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Posterior Urethral Valves
Sara M. O'Hara, MD, FAAP
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Posterior urethral valves (PUV)
          • Definitions

            • PUV: Varying degrees of chronic urethral obstruction due to fusion &/or prominence of plicae colliculi (which are normal concentric folds within posterior urethra)
            • Valve bladder: Varying degrees of urinary bladder dysfunction secondary to chronic bladder obstruction

          IMAGING

          • General Features

            • Radiographic Findings

              • Fluoroscopic Findings

                • Ultrasonographic Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      • Other Modality Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            Selected References

                                            1. Bilgutay AN et al: Posterior urethral valves: risk factors for progression to renal failure. J Pediatr Urol. 12(3):179.e1-7, 2016
                                            2. Sananes N et al: Two-year outcomes after diagnostic and therapeutic fetal cystoscopy for lower urinary tract obstruction. Prenat Diagn. 36(4):297-303, 2016
                                            3. Coleman R et al: Nadir creatinine in posterior urethral valves: how high is low enough? J Pediatr Urol. 11(6):356.e1-5, 2015
                                            4. Jesus LE et al: Pre-transplant management of valve bladder: a critical literature review. J Pediatr Urol. 11(1):5-11, 2015
                                            5. Clayton DB et al: Lower urinary tract obstruction in the fetus and neonate. Clin Perinatol. 41(3):643-59, 2014
                                            6. Ruano R et al: Fetal intervention for severe lower urinary tract obstruction: a multicenter case-control study comparing fetal cystoscopy with vesico-amniotic shunting. Ultrasound Obstet Gynecol. 45(4):452-8, 2014
                                            7. Thakkar D et al: Epidemiology and demography of recently diagnosed cases of posterior urethral valves. Pediatr Res. 76(6):560-3, 2014
                                            8. Lopez Pereira P et al: Long-term consequences of posterior urethral valves. J Pediatr Urol. 9(5):590-6, 2013
                                            9. Sarhan OM et al: Did antenatal diagnosis protect against chronic kidney disease in patients with posterior urethral valves? A multicenter study. Urology. 82(6):1405-9, 2013
                                            10. Fine MS et al: Posterior urethral valve treatments and outcomes in children receiving kidney transplants. J Urol. 185(6 Suppl):2507-11, 2011
                                            11. Krishnan A et al: The anatomy and embryology of posterior urethral valves. J Urol. 175(4):1214-20, 2006
                                            12. McMann LP et al: Magnetic resonance urography in the evaluation of prenatally diagnosed hydronephrosis and renal dysgenesis. J Urol. 176(4 Pt 2):1786-92, 2006
                                            13. Mercado-Deane MG et al: US of renal insufficiency in neonates. Radiographics. 22(6):1429-38, 2002
                                            14. Kraus SJ: Genitourinary imaging in children. Pediatr Clin North Am. 48(6):1381-424, 2001
                                            15. Fernbach SK et al: Pediatric voiding cystourethrography: a pictorial guide. Radiographics. 20(1):155-68; discussion 168-71, 2000
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Clinical Issues

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Posterior urethral valves (PUV)
                                                    • Definitions

                                                      • PUV: Varying degrees of chronic urethral obstruction due to fusion &/or prominence of plicae colliculi (which are normal concentric folds within posterior urethra)
                                                      • Valve bladder: Varying degrees of urinary bladder dysfunction secondary to chronic bladder obstruction

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • Fluoroscopic Findings

                                                          • Ultrasonographic Findings

                                                            • MR Findings

                                                              • Nuclear Medicine Findings

                                                                • Other Modality Findings

                                                                  • Imaging Recommendations

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Staging, Grading, & Classification

                                                                          • Gross Pathologic & Surgical Features

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      Selected References

                                                                                      1. Bilgutay AN et al: Posterior urethral valves: risk factors for progression to renal failure. J Pediatr Urol. 12(3):179.e1-7, 2016
                                                                                      2. Sananes N et al: Two-year outcomes after diagnostic and therapeutic fetal cystoscopy for lower urinary tract obstruction. Prenat Diagn. 36(4):297-303, 2016
                                                                                      3. Coleman R et al: Nadir creatinine in posterior urethral valves: how high is low enough? J Pediatr Urol. 11(6):356.e1-5, 2015
                                                                                      4. Jesus LE et al: Pre-transplant management of valve bladder: a critical literature review. J Pediatr Urol. 11(1):5-11, 2015
                                                                                      5. Clayton DB et al: Lower urinary tract obstruction in the fetus and neonate. Clin Perinatol. 41(3):643-59, 2014
                                                                                      6. Ruano R et al: Fetal intervention for severe lower urinary tract obstruction: a multicenter case-control study comparing fetal cystoscopy with vesico-amniotic shunting. Ultrasound Obstet Gynecol. 45(4):452-8, 2014
                                                                                      7. Thakkar D et al: Epidemiology and demography of recently diagnosed cases of posterior urethral valves. Pediatr Res. 76(6):560-3, 2014
                                                                                      8. Lopez Pereira P et al: Long-term consequences of posterior urethral valves. J Pediatr Urol. 9(5):590-6, 2013
                                                                                      9. Sarhan OM et al: Did antenatal diagnosis protect against chronic kidney disease in patients with posterior urethral valves? A multicenter study. Urology. 82(6):1405-9, 2013
                                                                                      10. Fine MS et al: Posterior urethral valve treatments and outcomes in children receiving kidney transplants. J Urol. 185(6 Suppl):2507-11, 2011
                                                                                      11. Krishnan A et al: The anatomy and embryology of posterior urethral valves. J Urol. 175(4):1214-20, 2006
                                                                                      12. McMann LP et al: Magnetic resonance urography in the evaluation of prenatally diagnosed hydronephrosis and renal dysgenesis. J Urol. 176(4 Pt 2):1786-92, 2006
                                                                                      13. Mercado-Deane MG et al: US of renal insufficiency in neonates. Radiographics. 22(6):1429-38, 2002
                                                                                      14. Kraus SJ: Genitourinary imaging in children. Pediatr Clin North Am. 48(6):1381-424, 2001
                                                                                      15. Fernbach SK et al: Pediatric voiding cystourethrography: a pictorial guide. Radiographics. 20(1):155-68; discussion 168-71, 2000