ABSTRACT
A posterior urethral valve, or more recently described as a congenital obstructive posterior urethral membrane, is a structure that originates from the inferior margin of the verumontanum exclusively in males. Children may demonstrate hyperkalemia, a raised nadir creatinine, abnormal plasma osmolality, coagulopathy, and/or a severe metabolic acidosis. There is no objective evidence to suggest which directional combination of valve leaflet resections is the most effective. UTIs occurring during childhood after successful valve ablation are often due to incomplete bladder emptying. Double or triple micturition should be tried before instituting clean intermittent catheterizations. A progressive rise in plasma creatinine is often seen during childhood, and in the most severe cases, renal transplantation may be required before puberty. Persistent urinary incontinence is an indication for cystometrography pressure-flow urodynamics. Since a considerable number of PUV patients with high-pressure bladders eventually develop myogenic failure, some units advocate postponing augmentation in this population, as long as they are under close surveillance.
