Delayed Presentation of Posterior Urethral Valve with Enuresis

Abstract

Posterior urethral valve (PUV) is the commonest cause of lower urinary tract obstruction in male infants. Persistent obstruction can lead to obstructive uropathy and renal impairment. PUVs can be diagnosed in-utero using antenatal ultrasound and postnatally. There is a varied mode of presentations among infants with PUV. This 12-year old boy presented with enuresis due to overflow incontinence from chronic urinary retention. The diagnosis was confirmed with micturating cystourethrogram (MCUG) and he subsequently had valvotomy using Mohan's valvotome. This unusual presentation underscores the spectrum of clinical findings associated with PUVs. It adds to the small, but growing, body of literature on delayed PUV presentation and emphasizes the importance of a high degree of clinical suspicion when evaluating boys of any age with LUTS and unusual urologic complaints.