Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be

talking to you about posterior urethral valves. And if you want to follow along with written notes on this

topic, you can follow along at zero tofinals.com slash puv or in the renal and urology section of the zero definals pediatrics book.

So let's get straight into it.

A posterior urethral valve is where there is tissue at the proximal end of the urethra,

closest to the bladder that causes obstruction of urine outflow.

It occurs in newborn boys.

The obstruction to the outflow of urine creates a back pressure into the bladder,

uritus and up to the kidneys, causing hydronephrosis.

A restriction in the outflow of urine prevents the bladder from fully emptying,

which leaves a reservoir of urine that increases the risk of urinary tract infections.

Let's talk about the presentation.

It can vary in severity, mild cases may be asymptomatic,

and more significant cases can present with difficulty urinating, weak urinary stream,

chronic urinary retention, a palpable bladder on examination, recurrent urinary tract infections

and impaired kidney function. Severe cases can cause obstruction to urine outflow in the developing fetus,

and this results in bilateral hydronephrosis and oligohydramneous,

which is a low level of amniotic fluid.

The oligohydramneous leads to underdeveloped fetal lungs,

which we call pulmonary hypoplasia

with respiratory failure shortly after birth.

Let's talk about the investigations.

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