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Posterior urethral valves — RACP Paediatrics MCQ

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ModerateNephrologyPosterior urethral valvesRACP Paediatrics

A male neonate presents with poor urinary stream, bilateral hydronephrosis on antenatal ultrasound, a palpable distended bladder, and rising creatinine. Voiding cystourethrogram shows a dilated posterior urethra with bladder trabeculation. What is the most likely diagnosis?

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Correct answer: D — Posterior urethral valves

Bilateral hydronephrosis with a distended bladder, poor urinary stream, and a dilated posterior urethra on VCUG in a male neonate is posterior urethral valves (PUV). This is the most common cause of severe obstructive uropathy in boys. Urgent bladder catheterisation followed by cystoscopic valve ablation is required. Renal function may be permanently impaired despite relief of obstruction.

Reference: RCH Melbourne – 2023 – Obstructive Uropathy CPG; RACP Paediatric Curriculum – Nephrology