Urology Surgery

Posterior urethral Valve

Posterior urethral valves (PUV) are obstructive membranes that form near the bladder in the urethra, tube that drains urine from the bladder. The valve can obstruct or block the outflow of urine through the urethra. Posterior urethral valves, are a rare birth defect that occurs only in male infants. Babies with posterior urethral valves have a tissue fold in the urethra that prevents urine (pee) from exiting the bladder.

When this occurs, the bladder, ureters and kidneys become progressively dilated, which can lead to damage.


The symptoms of posterior urethral valves can be mild to severe. A urinary tract infection is the most common symptom.

Other signs and symptoms may include:

  • Infant weight gain is inadequate.
  • Urination that is painful.
  • Urinary incontinence.
  • Kidney failure.

Tests and Treatment

The following tests can be performed to identify PUV and learn more about them:

  • Renal ultrasound
  • Voiding cystourethrogram
  • Cystoscopy
  • Blood test

In some children with severe PUV, the urine will reflux — back up into the kidneys — causing gradual kidney damage and eventually kidney failure. Urodynamic testing will be required to evaluate the bladder and monitor for any reflux.

Treatment for PUV is determined by the severity of the condition, child's age, bladder and kidney status, and other factors. The goal of the surgery is to preserve kidney and bladder function.

A minor surgical procedure to remove the obstructing valve is the most common treatment for posterior urethral valves.

  • Valve ablation: Once identified, PUVs must be surgically incised. The urologist will insert a cystoscope, a small device with a light and a camera lens at the end, during valve

Ablation. This tool will be used to make incisions in the valves, causing them to collapse and no longer obstruct the urethra.

  • Vesicostomy: If your baby is too small for valve ablation or there is a severe obstruction, a vesicostomy may be recommended. A vesicostomy opens the bladder, allowing urine to drain freely from the lower abdominal opening.

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