Article Sections

Introduction

Posterior urethral valves (PUV) are membranous folds that cause complete or partial obstruction of the prostatic urethral lumen ( Figure 1).  PUV are the most common cause of urinary tract obstruction in male infants.

Pathogenesis

By 14 weeks gestation, the pelvic and penile segments of the male urethra fuse to form a continuous, solid structure that later undergoes canalization.  Incomplete canalization results in an oblique membranous fold that extends anteriorly from the posterior urethral wall, causing varying degrees of urethral obstruction.  Elevated pressure proximal to the obstruction leads to dilation of the proximal urethra and hypertrophy of the bladder wall over time.  In addition, the elevated intravesical pressure prevents complete closure of the ureterovesical junction, allowing retrograde urine flow into the ureters (ie, secondary vesicoureteral reflux

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Figures

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Images

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