We reviewed 22 cases of posterior urethral valves over a five year per
iod (January 1986 to December 1990). We looked at initial management b
efore referral to the urologist, treatment and those factors that infl
uence the outcome. We found that nosocomial infection from catheters w
as the major source of morbidity and mortality. Other determinants of
outcome included postobstructive diuresis and the presence of refluxin
g or obstructing megaureters. The age of the patients was not as impor
tant as the degree of obstruction in this group of patients. We recomm
end percutaneous cystostomy as initial management for these patients a
s opposed to urethral catheterisation. This should be followed by ante
grade or retrograde valve ablation one week later depending on the siz
e of urethra.