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URETHRAL VALVES - A ‚YOUNG' DIAGNOSIS IN PAEDIATRIC UROLOGY
Wolfgang RÖSCH
Klinik St. Hedwig, University Medical Center of Regensburg, Department of Paediatric Urology, Regensburg, GERMANY
ABSTRACT
Morgagni was the first to describe posterior urethral valves (PUV) in 1717. The second mention of this condition found in
literature is the work of Langenbeck on lithotomy, published in 1802. Though he described valve-like folds in autopsy
specimens, he did not infer any clinical significance to these findings. It was only after 30 years the subject was again
referred to by Velpeau in 1832. He also commented on valve-like folds in several autopsy specimens but he felt they
might be of clinical importance. Again 38 years elapsed before the first comprehensive discussion of PUV was present by
Tolmatschew in 1870. He described the valves as well as the pathology of the bladder and the upper tracts precisely and
he was the first to recognize this as a pathological entity.
In the following years a great many almost identical cases had been described in European journals but up to 1912
there were no reports on PUV recorded in the American literature. Knox and Sprunt (1912) published the first case
report in the ‘American Journal of Diseases of Children' and made a very exhaustive study of the literature up to the
time their article appeared. Finally, in 1919 Young et al. described PUV as a clinical and pathological condition in 12
patients while giving an accurate description of the clinical presentation and the anatomy of PUV. Apart from open
questions and discussions on Young's classification of PUV this was a landmark paper and our understanding of the
anatomy and clinical course for boys with PUV has been enhanced by his work.
This presentation is an attempt to clarify the fascinating development of diagnosis and therapy of PUV by means of
literature and to some extend of original drawings and documents.