Posterior urethral valves

Abstract Congenital outflow obstruction due to posterior urethral valves (PUV) is the most common cause of renal dysplasia and renal failure in young males. PUV also create a substantial burden of ongoing morbidity that may extend throughout childhood and into later life. The majority of cases are now detected on antenatal ultrasonography. The results of fetal intervention have proved disappointing. Micturating cystourethrography is the definitive investigation. Treatment consists of endoscopic ablation or resection of the valve membrane. Wherever possible, follow-up should be provided jointly by paediatric urologists and nephrologists. Mild to moderate degrees of symptomatic bladder dysfunction usually resolve during childhood, whereas continent diversion and augmentation may be required in severe cases.