Congenital posterior urethral valves
Patients present with mild, moderate, or severe clinical symptoms of obstruction depending on severity and age of onset. Typical symptoms include abdominal mass representing a distended bladder, difficulty voiding, enuresis, failure to thrive, urinary frequency, urinary tract infection, and weak urinary stream. Common laboratory findings include anemia, azotemia, elevated serum creatinine, and elevated serum urea nitrogen.
In severe cases, complications include bladder dysfunction, renal impairment, respiratory distress, severe hydronephrosis, and vesicoureteral reflex. Patients are at increased risk of developing kidney failure. The most severe complication is pulmonary hypoplasia due to intrauterine oligohydramnios.
The presence of bilateral reflux or elevated nadir serum creatinine within the first year of life may indicate poor prognosis. A majority of these patients have delayed urinary continence development due to bladder changes and impairment of urinary concentration.
Treatment is dependent on the degree of obstruction; patients require individualized management. Treatment typically involves endoscopic ablation and resection, but may also include antibiotics, catheter drainage, and electrolyte and fluid imbalance correction.
Congenital posterior urethral valves – Q64.2
253900005 – Congenital posterior urethral valves