​Posterior Urethral Valve


Posterior urethral valve (PUV) is an abnormality of the urethra, the tube responsible for draining the urine, from the bladder, to the outside of the body. The abnormality occurs when extra flaps of tissue grow in the urethra, obstructing the normal flow of urine. This leads to reverse flow which can affect all the urinary tract organs including the bladder, ureters, and kidneys. The urinary tract organs swell due to the accumulation of urine, causing cell and tissue damage. PUV is a congenital disorder which means the disease is present at birth though it may not be diagnosed immediately after birth. While the exact cause of PUV is unknown, it is thought that the signal, sent by the body during foetal development, which tells the tissues to stop growing, fails to be delivered or picked up. This abnormality only affects baby boys and is usually sporadic (occurs by chance).

Symptoms may range from mild to severe depending on the degree of obstruction of the urethra. Your son’s symptoms may include:

  • Engorged bladder that may be detectable through the abdomen as a large mass

  • Painful and/or difficulty, with urination

  • Weak urine stream

  • Bedwetting even after toilet-training

  • Urinary tract infection

  • Frequent urination

  • Poor weight gain

Set an appointment with our doctors at the Children's Hospital Service Line at The Aga Khan University Hospital the only internationally accredited hospital in Pakistan, if you notice the above mentioned symptoms in your son for an accurate diagnosis and prompt treatment.

Your time with your doctor maybe limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.

In severe cases of PUV, your son may be diagnosed during a foetal ultrasound while the mother is still pregnant. Mild cases of PUV may get undetected until your child is much older or he develops urinary tract infection. An accurate diagnosis can require a number of tests including:

  • VCUG (Voiding cystourethrogram) in which a catheter (hollow tube) is placed in the urethra and a liquid dye is injected in the bladder. X-ray images are taken as the bladder fills and drains. These images determine if there is any reverse flow of the urine into the ureters and kidneys

  • Abdominal ultrasound, in which sound waves and a sensor is used to create an image on the computer to be studied by the doctor. Sound waves are sent by a handheld device that is moved across the abdomen

  • Endoscopy in which an endoscope (a small flexible tube with a light and a camera at the end) is inserted into the urethra to examine it and to collect tissue samples if required

  • Blood test to measure your child’s electrolytes and to determine kidney function

PUV can be treated successfully most of the times, provided it is diagnosed in its early stages. Our doctors at the Children's Hospital Services at The Aga Khan University Hospital are committed to focusing on your child’s needs. They will try their utmost best to provide exemplary treatment to your child all the while ensuring their comfort.

An individualized treatment plan will be generated for your child depending on the severity of the abnormality, your child’s age and general health, and your personal preference. The treatment may begin by alleviating your child’s symptoms such as urinary tract infection, electrolyte imbalance and dehydration using medications and IV (intravenous) fluids.

Following this initial treatment, a minimally invasive surgical procedure called endoscopic ablation is carried out. In this procedure an endoscope (a small flexible tube with a light and a camera at the end) is used to view the obstruction and trim down the excessive tissue of the valves through a small incision. 

Your child may require long term follow-ups with the doctor to determine that no long term damage has occurred to the urinary system

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage. 

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.



The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider. ​