title: Late presentation of posterior urethral valves.
abstract: Presence of posterior urethral valves (PUV) is the most common cause of urinary tract obstruction in the male neonate. Late presentation occurs in 10% of cases. We present a case of PUVs in an adult male who presented with history of obstructive lower urinary tract symptoms and hematuria. On evaluation, he was found to have raised serum creatinine level. A voiding cystourethrogram (VCUG) could not be completely performed because of narrowing in the posterior urethra. A rigid urethrocystoscopy was performed at which he was found to have type-I posterior urethral valve which were fulgurated. A repeat uroflowmetry revealed maximum flow rate of 12 ml/second. This case highlights that PUVs is not solely a disease of infancy but may also present late. VCUG is the radiological investigation of choice but the diagnosis may be missed. A urethrocystoscopy is advised if there is a high index of suspicion.
authors.affiliation: Department of Surgery, The Aga Khan University, Karachi.
authors.forename: Imran Khan
authors.initials: IK
authors.lastname: Jalbani
authors.affiliation: Department of Surgery, The Aga Khan University, Karachi.
authors.forename: Syed Raziuddin
authors.initials: SR
authors.lastname: Biyabani
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents; D003558:Cystoscopy; D004564:Electrocoagulation; D004926:Escherichia coli / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000188:drug therapy; D006417:Hematuria / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D017263:Technetium Tc 99m Mertiatide; D016896:Treatment Outcome; D014521:Urethra / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D014524:Urethral Obstruction / Q000000981:diagnostic imaging* / Q000601:surgery; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000382:microbiology; D014555:Urination Disorders / Q000209:etiology* / Q000601:surgery; D014567:Urography / Q000379:methods
chemical_list: D000900:Anti-Bacterial Agents; D019275:Radiopharmaceuticals; D017263:Technetium Tc 99m Mertiatide