Introduction:

the diagnosis of posterior urethral valves (PUV) has evolved due to the progress made in prenatal and postnatal imaging and evaluation techniques. Treatment options range from pharmacological therapies and surgical interventions to peritoneal dialysis. The management of preterm neonates with PUV requiring peritoneal dialysis is complex and necessitates a multidisciplinary approach that addresses both the complications of prematurity and those associated with PUV.

Objectives:

to describe the case of a preterm neonate (PTNB) with PUV who required peritoneal dialysis, emphasizing the complexities of managing PTNB with severe urological conditions and its implications for neonatal care.

Case report:

a PTNB at 31 weeks’ of gestation with prenatal oligohydramnios and suspected PUV presented at birth with respiratory distress and a distended bladder. Emergency percutaneous cystostomy was performed at 2 hours of life by the pediatric urology team. Abdominal ultrasound revealed moderate bilateral hydronephrosis, increased renal echogenicity, and multiple cysts. Renal function deteriorated, necessitating a vesicostomy at 8 days and the initiation of peritoneal dialysis at 13 days due to renal failure and fluid-electrolyte imbalances. The patient showed steady improvement in renal function and internal stability after 5 days of peritoneal dialysis.

Conclusions:

managing PTNB with PUV requiring peritoneal dialysis is multifaceted, requiring collaboration among neonatologists, pediatric urologists, pediatric nephrologists, and specialized neonatal nurses.

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