Posterior Urethral Valves

Posterior urethral valves (PUV) is when there are abnormal tissue flaps in the tube that lets urine flow from the bladder to outside the body (urethra).

Overview
Cause
Signs & Symptoms
Diagnosis
Treatment

What is are Posterior Urethral Valves?

Posterior urethral valves (PUV) is when there are abnormal tissue flaps in the tube that lets urine flow from the bladder to outside the body (urethra). The tissue flaps cause a blockage that back urine up into the bladder.  

This condition occurs in about 1 in every 8000 boys.

What Causes Posterior Urethral Valves?

There are no known causes of PUV. It may happen in the early stages of fetal growth.

What are the Signs and Symptoms of Posterior Urethral Valves?

Signs are usually seen on a routine 20-week ultrasound. They can include:

  • Bilateral hydronephrosis - when urine backs up into the kidneys, causing them to swell
  • Thickened smooth muscle trabeculation - when the muscle of the bladder becomes thick and loses its stretch (elasticity), which makes it hard to empty the bladder
  • Oligohydramnios - when there is a low amount of amniotic fluid around your baby
  • Pulmonary hypoplasia - when your baby’s lungs do not grow like they should
  • Bladder diverticula - when a pouch forms in the bladder lining and pokes through to the outside of the bladder wall

How is PUV Diagnosed?

After your baby is born, your baby’s doctor will confirm the diagnosis with one of these tests:

  • Voiding cystourethrogram - a special X-ray that looks at the urinary tract and bladder
  • Direct endoscopic visualization - test where a small, flexible tube with a camera and goes looks at the urethra

How is PUV Treated?

Most baby’s with PUV need a surgery called urethral valve ablation after they are born. Some medicines may be used to treat some symptoms of PUV, such as pain or urinary tract infections.

In severe cases of PUV, surgery on your baby before birth (fetal surgery) may be needed.

Possible Problems

If PUV is note treated, the back-up of urine can cause other organs in the urinary system to swell. This may lead to damage of the kidney, bladder or urinary tract. It can also cause infections and problems with peeing (urinating) as your child ages.

Oligohydramnios is a potential risk of PUV. This can affect how your baby’s lungs develop and constrict the umbilical cord. The umbilical cord is how your baby gets blood, food and oxygen from the mother. Your baby will be monitored during pregnancy to look for this problem.

Lifelong Considerations

In most mild cases, children will have normal urinary function again. Some children may have lasting problems and need more treatment for problems like urinary incontinence, frequency or urgency.

Next Steps
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