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Annals of Pediatric Surgery

Table 1 Clinical classification of PUV into distinct subgroups based on clinical criteria and response to therapy

From: The posterior urethral valves revisited: embryological correlation, clinical classification, and risk stratification of the spectrum

Group Clinical features
A Changes confined to the lower urinary tract (posterior urethra and urinary bladder) with normal ureters and kidneys. [(I) Responding to therapy i. (II) Not responding to therapy.]
B Involvement of the upper tracts, in addition to the lower tract changes. (Hydroureteronephrosis/megaureter/VUR) [(I) Responding to therapy ii. (II) Not responding to therapy.]
C Evidence of renal parenchymal damage iii. (Inherent renal dysplasia/acquired renal scarring or abnormal renal function tests). [(I) Responding to therapy iv. (II) Not responding to therapy.]
D Evidence of systemic complications v.
E End-stage renal disease/chronic renal failure.
  1. iPosterior urethral dilatation and bladder changes decreasing on serial VCUG and Cystoscopy
  2. iiHydroureteronephrosis and/or VUR decreasing on serial investigations
  3. iiiRenal cortical thinning on USS, decreased cortical function on isotope study
  4. ivFall in elevated RFT, absence of progressive renal scarring
  5. vMetabolic acidiosis/nephrogenic diabetes insipidus/hypertension/renal osteodystrophy/growth failure
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