Posterior urethral valve: delayed presentation in adolescence.

Area of Science:

• Pediatric Urology
• Medical Diagnostics
• Genitourinary Medicine

Background:

• Posterior urethral valves (PUV) are a congenital anomaly typically diagnosed in infancy.
• While most cases present early, some are diagnosed later in childhood, adolescence, or adulthood.
• Late presentation can be associated with lower urinary tract symptoms and varying degrees of renal function.

Purpose of the Study:

• To report an exceptionally rare case of posterior urethral valves diagnosed in a late adolescent.
• To discuss the unique presentation of preserved renal function and urinary incontinence in this patient.
• To review the literature regarding the presentation, natural history, and outcomes of early and late-presenting PUV.

Main Methods:

• Case report of a late adolescent diagnosed with posterior urethral valves.
• Comprehensive literature review of posterior urethral valves, focusing on presentation age and outcomes.
• Analysis of clinical data and diagnostic findings.

Main Results:

• The patient, a late adolescent, presented with urinary incontinence and preserved renal function, a rare initial presentation for posterior urethral valves.
• Literature review confirms that while antenatal diagnosis is common, delayed diagnosis into adolescence/adulthood is infrequent.
• Outcomes for late-presenting PUV vary, emphasizing the importance of considering this diagnosis in older patients with lower urinary tract symptoms.

Conclusions:

• Posterior urethral valves can present unusually late, even in late adolescence, with non-specific symptoms like incontinence and preserved renal function.
• This case underscores the importance of maintaining a high index of suspicion for PUV in older patients with unexplained urinary issues.
• Further research into the long-term outcomes and management strategies for late-presenting PUV is warranted.