Urinary extravasation in the newborn male with posterior urethral valves

Neonatal urinary extravasation is a rare condition frequently associated with posterior urethral valves in males. At the Babies Hospital, Columbia Presbyterian Medical Center during a 16-yr period, 5 neonates with urinary extravasation and valves presented--of all valve patients. Presentation was characterized by abdominal distention and varying degrees of azotemia. Treatment consisted of upper tract drainage in two cases and lower tract decompression in three. The mortality of this series was zero. At follow-up all five patients had completely normal serum renal function studies; four out of five had essentially normal radiographic studies. Extravasation appeared to protect the upper tracts from significant damage. Successful management of this condition should be tailored to the individual patient.