A 3 year old Boy presents with fever , dysuria and gross hematuria. Physical examination shows a prominent suprapubic area which is dull on percussion. Urinalysis reveals red blood cells but no proteinuria. Which of the following is the most likely diagnosis
High-Yield Explanation
A posterior urethral valve is an obstructing membrane in the posterior male urethra as a result of abnormal in utero development. It is the most common cause of bladder outlet obstruction in male newborns. The disorder varies in degree, with mild cases presenting late due to milder symptoms. A posterior urethral valve is an obstructing membrane in the posterior male urethra as a result of abnormal in utero development. M/C cause of bladder outlet obstruction in newborns Classification Type I (M/C) Anterior fusing of the plicae colliculi, mucosal fins extending from the bottom of the verumontanum distally along the prostatic and membranous urethra Type II (Least common) Veical/longitudinal folds b/w verumontanum and proximal prostatic urethra and bladder neck Type III (Less common) Disc of tissue distal to verumontanum, also theorized to be a developmental anomaly of congenital urogenital remnants in the bulbar urethra Reference: GHAI Essential pediatrics, 8th edition