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Table 2 Risk stratification approach to PUV; Risk strata to be assessed and recorded at diagnosis and during follow-up

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

Criteria Low risk Intermediate risk High risk
Posterior urethral dilatation; urinary bladder changes 1 Posterior urethral dilatation present; no bladder changes Moderate to severe changes Severe changes; persistent after therapy
Hydronephrosis/hydroureteronephrosis Mild (no calyceal dilatation) Moderate (with calyceal dilatation) Severe (with cortical thinning)
Vesicoureteric reflux Nil/mild (grade 1/2) Grade 3 Grade 4/5
Features of valve bladder syndrome Absent Absent Present
Renal function tests Normal Abnormal; normalizing with therapy Persistently abnormal
Renal parenchymal involvement2 Absent Unilateral, Mild (< 15%) functional deterioration Bilateral/moderate to severe (> 15%) functional deterioration
Systemic complications3 Absent Absent Present
  1. 1Based on VCUG and cystoscopy findings
  2. 2On isotope studies
  3. 3Metabolic acidosis/nephrogenic diabetes insipidus/hypertension/renal osteodystrophy/growth failure