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Posterior Urethral Valve (PUV) is a congenital obstructing membranous fold in the posterior urethra (prostatic urethra) in males.

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Results from abnormal persistence of embryological urogenital membrane.
It is the most common cause of lower urinary tract obstruction in male infants and children.

[Clinic C. Treating Posterior Urethral Valves Across the Lifespan. Cleveland Clinic. Published June 29, 2020. Accessed May 23, 2026. https://consultqd.clevelandclinic.org/treating-posterior-urethral-valves-across-the-lifespan ‌](attachment:00f8346e-5e52-411f-80f2-88133ea3a79e:805x-Posterior-Urethral-Valve_jpg.avif)

Clinic C. Treating Posterior Urethral Valves Across the Lifespan. Cleveland Clinic. Published June 29, 2020. Accessed May 23, 2026. https://consultqd.clevelandclinic.org/treating-posterior-urethral-valves-across-the-lifespan ‌

Epidemiology

Occurs exclusively in boys.
Incidence: ~1 in 5,000–8,000 live male births.
Often diagnosed antenatally (20–30 weeks) due to hydronephrosis and bladder changes.

Pathogenesis

Abnormal development of Wolffian duct–derived tissue → obstructing leaflets in the posterior urethra.
Causes high-pressure urinary obstruction → affects bladder, ureters, kidneys.
Leads to:
- Hydroureteronephrosis.
- Bladder dysfunction (“valve bladder” – thick, trabeculated, poorly compliant).
- Vesicoureteric reflux (VUR)
- Renal dysplasia (from in utero obstruction).

Antenatal