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A case of posterior urethral valve identified in an older child by straining to void

Hidenori Nishio1, Kentaro Mizuno1, Taiki Kato2

  • 1Department of Pediatric Urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.

Urology Case Reports
|October 29, 2021
PubMed

Insights

Posterior urethral valves (PUVs) can be difficult to diagnose. Voiding cystourethrography (VCUG) is crucial for identifying PUVs, even in cases with subtle symptoms, leading to improved voiding function.

Area of Science:

  • Pediatric Urology
  • Diagnostic Imaging

Background:

  • Posterior urethral valves (PUVs) represent the most frequent congenital urethral obstruction in children.
  • Accurate diagnosis of PUVs can present challenges, particularly in milder cases.

Observation:

  • A 13-year-old male presented with straining during urination, despite lacking overt complaints.
  • Uroflowmetry demonstrated a plateau-shaped curve, suggestive of obstruction.
  • Voiding cystourethrography (VCUG) definitively identified the presence of a PUV.

Findings:

  • Transurethral incision of the identified PUV was performed.
  • The patient experienced significant improvement in voiding status post-procedure.

Implications:

  • Mild PUVs may not manifest with obvious urinary symptoms, potentially delaying diagnosis.
  • VCUG should be considered a primary diagnostic tool when urethral lesions are suspected in pediatric patients.
  • Early and accurate diagnosis through VCUG can prevent long-term voiding dysfunction.

Keywords:
PUV, posterior urethral valvePosterior urethral valveStraining to voidTransurethral incisionUrethral obstructionVCUG, voiding cystourethrographyVUR, vesicoureteral reflux

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