Presentation
Renal failure.
Patient Data
Selected images of the patient's voiding cystourethrogram.
Dilatation and elongation of the posterior urethra are evident on the oblique views, consistent with posterior urethral valves.
Urinary bladder trabeculation is best appreciated on AP views.
Bilateral contrast-filled outpouchings are noted adjacent to the vesicoureteral valves, in keeping with the diverticula.
Associated vesicoureteral reflux, grade 5 on the right. There is no vesicoureteral reflux on the left.
Case Discussion
Children with posterior urethral valves usually present with lower urinary tract obstructive symptoms and repeated urinary tract infections. Renal failure, as in this case, is another frequent problem in boys with posterior urethral valves.
Urinary bladder diverticula are classified as congenital or acquired. Congenital diverticula are usually seen in the absence of bladder outlet obstruction and result from herniation of the mucosa through the muscular fibers of the bladder wall. A congenital bladder diverticulum located superolateral to the ureteral orifice without involving the trigone is referred to as a Hutch diverticulum. In this case, diverticula formation is related to the posterior urethral valves.
Unable to process the form. Check for errors and try again.