Posterior Urethral Valves

Frank H Miller, MD
Faye C Laing, MD

June 8, 1994

Presentation

This case from 1984 was a routine prenatal examination.

Imaging Findings

Ultrasound Examination

Ultrasound examination indicates that the fetus has a distended urinary bladder and proximal urethra (arrows). In addition, the bladder wall is mildly thickened and the ureters (arrows) are dilated.

Diagnosis

Posterior urethral valves

Discussion

Posterior urethral valves, which occur only in males, consist of mucosal folds that can obstruct the urethra and cause obstructive uropathy. Dilatation of the urinary bladder and proximal urethra are associated with a characteristic "keyhole" deformity at the bladder base and thickening of the bladder wall. Ureteral dilatation and hydronephrosis are visible in approximately 40% of cases. Oligohydramnios, present in about half of the cases, is a poor prognostic sign because it predisposes to pulmonary hypoplasia. Urethral obstruction in females may be associated with caudal regression syndrome, urethral atresia, and megacystis-microcolon- intestinal hypoperistalsis syndrome.

References

1. Mahony BS, Callen PW, Filly RA. Fetal urethral obstruction: US evaluation. Radiology 1985;157:221.

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