Expertise Area 1.5: Posterior urethral valves

Posterior urethral valves (PUV) are congenital membranous folds that emanate from the verumontanum on both sides, with an anterior oblique extension towards the midline where they fuse close to the external striated muscle sphincter. These folds obstruct urine flow through the posterior urethra, leading to bladder outflow obstruction (BOO) and, ultimately, renal functional impairment. Despite first being alluded to in postmortem studies in the late 18th and early 19th century, definitive clinical verification and classification of valves is ascribed to Hugh Hampton Young’s seminal paper from 1919, where PUV was first described in vivo, in three adult patients by either suprapubic cystostomy or cystourethroscopy. Young classified valves into three types according to the configuration and anatomy of the membranous leaflets.