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Posterior urethral valves obstruction — MRCPCH TAS MCQ

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HardEmbryologyPosterior urethral valves obstructionMRCPCH TAS

A male fetus has bilateral hydronephrosis, a thick-walled bladder and oligohydramnios. After birth he has poor urinary stream and respiratory distress. What is the most likely diagnosis?

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Correct answer: A — Posterior urethral valves

Posterior urethral valves cause lower urinary tract obstruction in male infants, producing bilateral hydronephrosis and oligohydramnios. Multicystic dysplastic kidney is usually unilateral and would not explain a thick-walled obstructed bladder. The pearl is that oligohydramnios from fetal urinary obstruction can impair lung development.

Reference: Nelson Textbook of Pediatrics; Gray's Anatomy; RCPCH Theory examination syllabi