Introduction
Posterior Urethral Valves is a congenital mucosal folds situated in the prostatic/ membranous urethra, causing
urine outflow obstruction.
It occurs in males.
It is the most common mechanical cause of renal deterioration in children.
Clinical features
Obstructive urinary symptoms
- Urinary retention
- Failure to thrive
- Distended bladder with palpable kidneys
Differential diagnoses
- Anterior urethral valves
- Congenital bladder neck hypertrophy
- Congenital urethral stricture
- Meatal stenosis
- Posterior urethral polyp
Complications
- Recurrent urinary tract infections
- Septicaemia
- Bladder dysfunction
- Bladder stones
- Hydroureter/hydronephrosis
- Progressive renal impairment
- Failure to thrive
Investigations
- Urinalysis
- Urine microscopy, culture and sensitivity
- Full Blood Count
- Serum Urea, Electrolytes and Creatinine
- Abdominal ultrasound
- Micturating cysto-urethrogram
- Urethrocystoscopy
Treatment
Treatment objectives
- To relieve obstruction
- Treat any complications
Non-drug treatment
- Valve resection with endoscopes
- Valve avulsion with valvotomes
Drug treatment
- None
- Supportive measures
- Correct dehydration and electrolyte
imbalance - Treat infection with appropriate antibiotics
- Urinary diversion: vesicostomy
Prevention
- Not applicable