Posterior urethral valves


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Posterior urethral valves

Renal system

Renal and ureteral disorders

Renal agenesis

Horseshoe kidney

Potter sequence











Renal tubular acidosis

Minimal change disease

Diabetic nephropathy

Focal segmental glomerulosclerosis (NORD)


Membranous nephropathy

Lupus nephritis

Membranoproliferative glomerulonephritis

Poststreptococcal glomerulonephritis

Goodpasture syndrome

Rapidly progressive glomerulonephritis

IgA nephropathy (NORD)

Lupus nephritis

Alport syndrome

Kidney stones


Acute pyelonephritis

Chronic pyelonephritis

Prerenal azotemia

Renal azotemia

Acute tubular necrosis

Postrenal azotemia

Renal papillary necrosis

Renal cortical necrosis

Chronic kidney disease

Polycystic kidney disease

Multicystic dysplastic kidney

Medullary cystic kidney disease

Medullary sponge kidney

Renal artery stenosis

Renal cell carcinoma


Nephroblastoma (Wilms tumor)

WAGR syndrome

Beckwith-Wiedemann syndrome

Bladder and urethral disorders

Posterior urethral valves

Hypospadias and epispadias

Vesicoureteral reflux

Bladder exstrophy

Urinary incontinence

Neurogenic bladder

Lower urinary tract infection

Transitional cell carcinoma

Non-urothelial bladder cancers

Renal system pathology review

Congenital renal disorders: Pathology review

Renal tubular defects: Pathology review

Renal tubular acidosis: Pathology review

Acid-base disturbances: Pathology review

Electrolyte disturbances: Pathology review

Renal failure: Pathology review

Nephrotic syndromes: Pathology review

Nephritic syndromes: Pathology review

Urinary incontinence: Pathology review

Urinary tract infections: Pathology review

Kidney stones: Pathology review

Renal and urinary tract masses: Pathology review


Posterior urethral valves


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High Yield Notes

7 pages


Posterior urethral valves

of complete

External References

First Aid


Posterior urethral valve p. 549


Content Reviewers

Rishi Desai, MD, MPH


Tanner Marshall, MS

Posterior urethral valve, or PUV, is a congenital disorder in boys where the posterior urethra, which is the section of the urethra nearest the bladder, is obstructed by membranous folds, or flaps of tissue. These flaps of tissue are collectively referred to as a congenital obstructive posterior urethral membrane, or COPUM.

This blockage means urine can’t easily flow out, which leads to a backup of urine which can cause kidney problems, as well as less amniotic fluid which can cause respiratory problems.

Although the cause of PUV isn’t completely understood, it’s thought that normal development of the male urethra is disrupted between weeks 9 and 14 of gestation.

Normal development involves the Wolffian duct integrating with the posterior urethra, which results in thin mucosal folds called plicae colliculi.

It’s thought that PUV might result from abnormal integration of the wolffian duct, resulting in large plicae colliculi that fuse anteriorly, making it more difficult for urine to flow through.

When that urine can’t easily flow out because of increased resistance from an obstruction, the intravesical pressure, or bladder pressure, starts to creep up.

Holding urine under higher pressure leads to bladder wall hypertrophy and collagen deposition, both of which thicken the bladder wall. This thickening makes the bladder less compliant, meaning that small increases in urine volume causes large increases in bladder pressure, which makes the problem even worse.

That high-pressure urine has nowhere to go but up to the ureters and eventually to the kidneys, causing hydronephrosis, which is the swelling of a kidney due to a buildup of urine.


Posterior urethral valves (PUV), also referred to as congenital obstructive posterior urethral membrane, is a urologic disorder affecting boys where membranous folds obstruct the normal flow of urine. This leads to bladder outlet obstruction, causing high bladder pressure that causes vesicoureteral reflux. The reflux of urine back up into the ureters and kidneys leads to urinary stasis, which can lead to recurrent urinary tract infections; and hydronephrosis, which is the swelling of a kidney due to a buildup of urine. Treatment involves surgery and ablation of the membrane, which allows urine to flow through unobstructed.


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  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Aggressive diagnosis and treatment for posterior urethral valve as an etiology for vesicoureteral reflux or urge incontinence in children" Investigative and Clinical Urology (2017)
  6. "Antenatal oligohydramnios of renal origin: long-term outcome" Nephrology Dialysis Transplantation (2006)
  7. "Posterior Urethral Obstruction: COPUM" Bangladesh Journal of Endosurgery (2014)

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