Infant referred with diagnosis of urinary tract infection. Transabdominal ultrasound revealed bilateral hydronephrosis/hydroureter and over-distended, trabeculated walled urinary bladder. Transperineal (trans-pubic symphysis) ultrasound revealed dilated posterior urethra at urinary bladder base.

MCU (courtesy Dr Ninad Shah) revealed posterior urethral valve and right sided grade V reflux.

Surgery revealed posterior urethral valve.