Posterior Urethral Valves (PUV)
Understanding Diagnosis, Treatment, and Management of Posterior Urethral Valves
Illustration showing PUV blockage in the urethra
What are posterior urethral valves?
A posterior urethral valve (PUV) is a birth defect (congenital disorder) where tissue blocks the tube that pee (urine) travels through to leave your body (urethra). This means your bladder can't empty properly, and pee can back up and cause damage to your bladder and kidneys.
PUV is a congenital condition, meaning you're born with it. A healthcare provider might diagnose PUV during pregnancy, shortly after birth or during childhood. It only affects males. It's also called congenital obstructive posterior urethral membrane (COPUM).
Symptoms and Causes
What are the symptoms of posterior urethral valves?
Symptoms of posterior urethral valves can vary depending on the severity of the blockage and when it's diagnosed.
Symptoms include:
- Weak or dribbling stream of pee
- Urinary tract infections (UTIs)
- Poor weight gain in infants
- Painful urination (dysuria)
- Difficulty peeing
- Low amniotic fluid (oligohydramnios)
- Kidney dilation (hydronephrosis), seen on prenatal ultrasound
What are the complications of posterior urethral valves?
PUV can lead to several complications if not treated promptly:
Diagnosis and Tests
How are posterior urethral valves diagnosed?
Sometimes, a provider diagnoses posterior urethral valves with an ultrasound during pregnancy. At or after birth, a provider might use one or more of these tests to diagnose PUV:
Kidney ultrasound
An ultrasound can help your provider see any blockages or differences in how your child's kidneys, bladder and urinary tract look.
Voiding cystourethrogram
This lets your provider see how well your child's bladder fills and empties. This will also show the urethra and any areas of narrowing.
Cystoscopy
Your provider uses a small, flexible tube with a light and a camera at the end to look inside your child's urinary tract.
Kidney function tests
Blood or urine (pee) tests can help to determine how well your child's kidneys are working.
Management and Treatment
How are posterior urethral valves treated?
Treatment for posterior urethral valves is usually a procedure to remove or destroy the blockage. A provider often does this with fulguration — using electricity to destroy the tissue with heat.
Depending on any other issues, a provider may also treat your child with:
Note: In some rare cases, a specialist may perform surgery on the fetus while you're still pregnant.
Key Takeaways
About PUV
- • Congenital condition present at birth
- • Only affects males
- • Tissue blockage in the urethra
- • Also called COPUM
Diagnosis & Treatment
- • Often diagnosed via prenatal ultrasound
- • Main treatment is valve ablation/fulguration
- • Requires long-term kidney monitoring
- • Early detection prevents kidney damage