Condition

Pediatric Posterior Urethral Valve

Key Points About Posterior Urethral Valves in Children

Posterior urethral valves are a problem with the urethra in a boy. The urethra is the tube that drains urine from the bladder to the outside of the body.
These valves are small leaflets of tissue in the urethra. They partly block urine flow because not enough urine can get through them to leave the body. This causes a reverse flow of urine.
These valves can harm the urethra, bladder, ureters and kidneys. They become too full of urine and swell. This leads to tissue damage.
These valves likely happen early in the growth of a baby boy in the uterus.
They are often diagnosed by fetal ultrasound while a woman is still pregnant.
Treatment may include removing the valves with surgery.

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Frequently Asked Questions

What are posterior urethral valves in children?

Posterior urethral valves are a problem with the urethra in a boy. The urethra is the tube that drains urine from the bladder to the outside of the body. Posterior urethral valves are small leaflets of tissue in the urethra. They have a narrow, slit-like opening. The valves partly block urine flow because not enough urine can get through them to leave the body. This causes a reverse flow of urine. This can harm the urethra, bladder, ureters and kidneys. They become too full of urine and swell. This leads to tissue damage. Posterior urethral valves are the most common cause of severe urinary tract blockage in children.

What causes posterior urethral valves in a child?

What are the symptoms of posterior urethral valves in a child?

Symptoms can be a bit different for each child. They may be mild to severe. The most common symptoms include:

An enlarged bladder that can be felt through the belly
Pain when urinating
Weak urine stream
Feeling the need to urinate often
Bedwetting or pants wetting after toilet training
Poor weight gain
Urinary tract infection (rare unless there is a blockage)

The symptoms of posterior urethral valves can seem like other health conditions. Have your child see his healthcare provider for a diagnosis.

How are posterior urethral valves diagnosed in a child?

Posterior urethral valves are often diagnosed by fetal ultrasound while a woman is still pregnant.

A child diagnosed later often has urinary tract infections. The healthcare provider will ask about your child’s symptoms and health history. They will give your child a physical exam. Your child may also have tests, such as:

Abdominal ultrasound. This imaging test uses sound waves and a computer to create images of blood vessels, tissues and organs. The test is used to view internal organs as they work. It also looks at blood flow through vessels.
Voiding cystourethrogram (VCUG). This is a type of X-ray to look at the urinary tract. The healthcare provider puts a thin, flexible tube (catheter) in the urethra. He or she fills the bladder with a liquid dye. The provider takes X-ray images as the bladder fills and empties. The images show if there is any reverse flow of urine into the ureters and kidneys.
Cystoscopy. This test uses a small, flexible tube with a light and a camera lens at the end (cystoscope). The scope is used to look inside part of the urinary tract. The healthcare provider may take tissue samples from inside the urinary tract for testing.
Blood test. This test may be done to check your child's electrolytes and kidney function.

How are posterior urethral valves treated in a child?

Treatment will depend on your child’s symptoms, age and general health. It will also depend on how severe the condition is. Your child may see a urologist. This is a healthcare provider who treats the urinary tract and the male genital tract. Treatment may include:

Supportive care. At first, treatment may focus on easing your child's symptoms. If your child has a UTI, is dehydrated, or has electrolyte problems, these conditions will be treated first. Your child may have a catheter placed in his bladder. This is a thin, flexible tube that is put into the penis through the urethra and is gently moved up into the bladder. Your child may also be given antibiotics and IV (intravenous) fluids.
Cystoscopic ablation. This procedure is done to remove the valves and other blockages. It’s done with a small, flexible tube with a light and a camera lens at the end (cystoscope).
Vesicostomy. The healthcare provider makes a small opening in the bladder through the belly. The opening is fixed at a later time when the valves can be cut more safely.

Talk with your child’s healthcare providers about the risks, benefits and possible side effects of all treatments.

What are possible complications of posterior urethral valves in a child?

When should I call my child’s healthcare provider?

Meet the Providers Who Treat Posterior Urethral Valve

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Departments that Treat Posterior Urethral Valve

Neonatology

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