Congenital anterior urethral valve

　　The etiology of congenital anterior urethral valve and diverticulum is not yet clear. It may be that the urethral plate does not fuse completely at some stage during embryogenesis, or that the urethral corpus spongiosum is underdeveloped, causing the local urethra to lack supporting tissue, resulting in the mucosa protruding outward. The anterior urethral valve is generally located on the ventral side of the anterior urethra at the junction of the penis and scrotum, with two mucosal flaps extending from the dorsal side of the urethra to the midline of the ventral side of the urethra, forming a cleft in the middle, resembling the vocal cords. Like the posterior urethral valve, it does not obstruct the insertion of a catheter but blocks the excretion of urine, causing dilation of the proximal urethra. In severe obstruction, renal pelvis and ureteral dilation may occur, and some may be accompanied by urethral diverticulum.

　　Congenital anterior urethral valve can be complicated by urinary tract infection. Severe obstruction in infants can lead to sepsis and severe electrolyte disorder when seeking medical attention, and some may seek medical attention due to abdominal mass or delayed growth and development. If secondary infection occurs, there may be local pain, swelling, and tenderness, with purulent urine excreted when pressing on the diverticulum. When the diverticulum breaks through the skin, a urinary fistula can form. When this disease is complicated by calculus, it has a hard and sandy feeling when tapped.

　　Patients with congenital anterior urethral valve have symptoms such as difficulty urinating, dribbling, and a large amount of residual urine in the bladder. When the diverticulum is filled with urine, a bulge can appear at the junction of the penis and scrotum, with dripping after urination. Applying pressure to the lump can cause urine to be expelled.

　　The etiology of anterior urethral valves and diverticula in embryology is not yet clear. It may be due to incomplete fusion of the urethral plate at a certain stage during embryogenesis, or it may be due to incomplete development of the urethral corpus spongiosum, resulting in a lack of supporting tissue in the local urethra, causing the urethral mucosa to protrude outward. Therefore, there is no direct prevention for this disease. Early detection, early diagnosis, and early treatment are of great significance for indirect prevention of the disease. Regular examinations should be done during pregnancy, and if the child shows a tendency of developmental abnormalities, chromosomal screening should be done in a timely manner.

　　Congenital anterior urethral valves are often observed for the presence of stones through urinary system X-ray films, and intravenous urography is used to understand the condition of the upper urinary tract. Severe anterior urethral valves often cause renal pelvis and ureteral hydrops, and intravenous urography and renal radionuclide scanning can understand renal function and segmental renal function, and urodynamic examination should be performed. Voiding urography shows urethral dilation near the proximal urethra at the penoscrotal junction, and in the presence of diverticula, the urethral ventral diverticulum image can be seen. The distal urethra is extremely narrow, and the bladder may have trabeculae and diverticula, and there may be vesicoureteral reflux. Urethral cystoscopy can clearly observe the shape and position of the valve.

　　The diet of patients with congenital anterior urethral valve should be light, with an emphasis on eating more vegetables and fruits such as bananas, strawberries, apples, etc., as they are rich in nutritional components. Eat more immune-boosting foods like propolis to enhance personal disease resistance. It is also necessary to have a reasonable dietary arrangement to ensure adequate nutrition. Avoid cold and spicy foods to prevent recurrent attacks of disease.

　　The treatment of congenital anterior urethral valve mainly involves surgical resection of the valve and diverticulum. If it is a simple anterior urethral valve, the valve can also be cauterized through the urethra. In newborns, a diverticulectomy can be performed first, followed by the resection of the diverticulum and repair of the urethra. For infants with electrolyte imbalance and urinary tract infections, correction is required, control of urinary tract infections, and placement of a catheter to drain urine, followed by the treatment of the urethral valve after the condition improves.