Overview

Posterior urethral valves (PUV) is a condition that only affects males. It can be diagnosed before or shortly after birth, and is usually treated in childhood. 

PUV affects the urethra, the tube that carries your urine (pee) from the bladder to the outside of the body. In PUV, the urethra has a blockage close to the bladder. This makes it harder for urine to pass and may cause pressure that can damage the bladder and kidneys. 

Once the blockage has been removed, the bladder and kidneys may continue to be affected. You will need long‑term follow‑up appointments to check that no further damage is being done, even if you feel well. 

Causes of PUV

The exact case of PUV is unknown. It's not recognised as a hereditary condition (passed on from parent to child). It seems to develop in early stages of pregnancy when the organs, muscle and other tissue start to form.

Even though there are no known risk factors, the condition is sometimes seen in twins or siblings.

PUV does not develop in adulthood.

Diagnosis

PUV can be diagnosed during pregnancy. A routine ultrasound scan may show signs such as a swollen bladder, ureters or kidneys. 

It can also be diagnosed shortly after birth. Signs may include a swollen bladder and difficulty passing urine. 

If the blockage was not severe before or just after birth, PUV may not be detected straight away. In some cases, the condition is not diagnosed until symptoms develop during early childhood.

Symptoms of PUV

PUV can affect people in different ways. Some people have no damage to their kidneys or bladder. If this is the case, you may not have symptoms.

If your kidneys or bladder have been severely affected, you will need to have regular checks to monitor your condition.

Kidney damage does not usually cause symptoms until the kidneys start to fail, which is why it's important you attend any follow up appointments. 

If your bladder is damaged, you may have no symptoms at all. Or, you may notice some or more of these symptoms: 

• needing to pee very often
• needing to pee urgently
• urinary tract infections (UTIs) 
• urinary incontinence (unable to get to the toilet in time)
• taking a long time to start peeing 
• a weak urine stream
• feeling like your bladder has not fully emptied after peeing

Treatment

If your PUV was diagnosed before or shortly after birth, or when you were very young, it's likely that you were treated when you were a child. Treatment usually involves surgery to remove the valves causing the blockage.

Any further treatment you may need depends on whether your kidneys or bladder are affected. If there is ongoing damage, there are several treatment options available. These will depend on how severe your condition is and how it affects you.

Your healthcare team will discuss the most appropriate options with you.

Looking after yourself

If you have been diagnosed with PUV, there are some simple steps you can take to help look after yourself.