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Welcome, medical contents search April 25, 2013
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Posterior Urethral Valves

more about Posterior Urethral Valves

  • This condition refers to folds of tissue, or membranes, that develop antenatally (prior to birth) in affected males, and often produce various symptoms -- ranging from mild to severe   -- in the first month of life.
  • Posterior urethral valves obstruct or partially obstruct the prostatic urethra, which leads to dilation of the urinary tract behind the obstruction, and therefore leads to hydroureter (abnormal swelling of the ureter) and hydronephrosis (distention of kidney).  There is hypertrophy (enlargement) of the bladder neck, from pushing against the obstruction.
  • There are three types of obstruction:
    1. Type 1: sail-shaped
    2. Type 2: folds 
    3. Type 3: membranes
  • There might be a similar fold or membrane in some females, not identical to the condition in males.

    1. Distended bladder
    2. Bulging flanks due to enlarged kidneys or ascites (fluid in the abdomen)
    3. Firm palpable bladder
    4. Hematuria (i.e., blood in the urine)
  • Some apparently normal newborns develop decreased appetite and lethargy, becoming severely ill and septic from PUV.

  • A defect in fetal development, not known to be hereditary

  • Oligohydramnios -- less than the normal amount of amniotic fluid -- may be an indication of this condition antenatally.  Decreased fetal urine output causes less amniotic fluid; thus, less than the normal increase in size of the maternal uterus.
  • Fetal ultrasound shows a distended fetal bladder that is still distended on any repeat ultrasounds.
  • In the newborn period, the above symptoms and signs in males, suggest this condition.
  • Increased serum creatinine
  • In older boys, a voiding cystourethrogram (VCUG) shows the condition.
  • Some boys with non-resolving enuresis (urinary incontinence after the age when control should be mastered), or who have hematuria, undergo a VCUG that shows the condition.

  • Male sex

  • Procedures on the fetus, to relieve the obstruction, in some cases
  • Fetal surgery, in some cases
  • Antibiotics for infection
  • Possible drainage of the bladder with a catheter, and surgery for the infant or older child

  • Renal failure or renal damage/hydronephrosis
  • Sepsis
  • Urinary ascites
  • Reflux of urine into the ureters/kidneys

  • Consult your child's physician for the above symptoms.
  • This could lead to serious complications, so don't postpone medical consultation if you suspect this condition in your child.

  • A small percentage of normal boys do not void until 48 hours after birth.
  • Multicystic kidney can cause a flank mass.
  • Obstruction at the UP (ureteropelvic) junction where the kidney joins the ureter, can cause a flank mass.
  • Other causes of decreased urine output
  • "Prune belly" syndrome

more about Posterior Urethral Valves

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