Posterior Urethral Valve In A Six Year Old Boy With Nocturnal Eneuresis And Failure To Thrive As The Only Symptoms

We report a case of posterior urethral valve (PUV) in a six year old boy with nocturnal eneuresis and failure to thrive as the only presenting symptoms. The clinically occult lesion was only unravelled when micturating cysto-urethrogram revealed a dilated posterior urethra with a distal narrow stream of opacified urine, bilateral hydronephrosis and hydroureters, thus confirming an obstructive uropathy due to posterior urethral valves. Eneuresis and haematuria are both documented symptoms of PUV which are barely mentioned at clinical rounds. In an entity where delay in diagnosis could result in irreversible renal damage, the need to raise the index of suspicions for, eneuresis and haematuria (especially microscopic haematuria), as important sysmptoms and sign in PUV is emphasized. The need to remember genitourinary infections in the search for causes of recurrent PUO in the paediatric patient is readdressed.