Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Imaging Case Report
  • Published:

Neonatal presentation of posterior urethral valves and tethered spinal cord

Journal of Perinatology volume 34, pages 647–648 (2014)Cite this article

Subjects

The renal ultrasound demonstrated moderate bilateral hydroureteronephrosis, echogenic renal cortices relative to the hepatic and splenic parenchyma and a thickened, trabeculated urinary bladder wall with a dilated prostatic urethra (Figure 1) consistent with bladder outlet obstruction and posterior urethral valves. The subsequent VCUG confirmed a thick-walled, trabeculated urinary bladder with dilated prostatic urethra and filling of prostatic ducts, confirming posterior urethral valves (Figure 2). The spinal sonogram showed an abnormally low position of the conus medullaris at L4, consistent with a tethered cord (Figure 3a). This was confirmed by the spine MRI, which demonstrated a tethered cord with the conus of the cord at the L3–L4 and an associated filum terminale lipoma (Figure 3b).

Cystourethroscopy at 12 days of life confirmed posterior urethra valves, which were ablated at day 6 of life. Subsequently, the obstructive uropathy and renal failure improved. The patient was then discharged to be followed up with neurosurgery for his tethered cord.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

References

  1. Bloom DA, Lebowitz RL, Bauer SB . Correlation of cystogrpahic bladder morphology and neuroanatomy in boys with posterior urethral valves. Pediatr Radiol 1997; 27: 553–556.

    Article  CAS  Google Scholar 

  2. Banever GT, Moriarty KP . Posterior urethral valves in a newborn with imperforate anus: clinical presentation and management. J Pediatr Surg 2005; 40: 1332–1334.

    Article  Google Scholar 

  3. Berrocal T, López-Pereira P, Arjonilla A, Gutiérrez J . Anomalies of the distal ureter, bladder, and urethra in children: embryologic, radiologic, and pathologic features. Radiographics 2002; 22: 1139–1164.

    Article  Google Scholar 

  4. Chen CP, Shih SL, Liu FF, Jan SW, Tsai TC, Chang PY et al. In utero urinary bladder perforation, urinary ascites, and bilateral contained urinomas secondary to posterior urethral valves: clinical and imaging findings. Pediatr Radiol 1997; 27: 3–5.

    Article  Google Scholar 

  5. Salam MA . Posterior urethral valve: outcome of antenatal intervention. Int J Urol 2006; 10: 1317–1322.

    Article  Google Scholar 

  6. Pieretti RV . The mild end of the clinical spectrum of posterior urethral valves. J Pediatr Surg 1993; 28: 701–706.

    Article  CAS  Google Scholar 

  7. Kupferman JC, Steward CL, Kaskel FJ, Fine RN . Posterior urethral valves in patients with Down syndrome. Pediatric Nephrol 1996; 10: 143–146.

    Article  CAS  Google Scholar 

  8. Hertzler DA, DePowell JJ, Stevenson CB, Mangano FT . Tethered cord syndrome: a review of the literature from embryology to adult presentation. Neurosurg Focus 2010; 29 (1): E1.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Mallinckrodt Institute of Radiology, St Louis Children’s Hospital, Washington University School of Medicine, St Louis, MO, USA

    S G Farmakis, T E Herman & M J Siegel

Authors
  1. S G Farmakis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T E Herman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M J Siegel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to T E Herman.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Farmakis, S., Herman, T. & Siegel, M. Neonatal presentation of posterior urethral valves and tethered spinal cord. J Perinatol 34, 647–648 (2014). https://doi.org/10.1038/jp.2014.10

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2014.10

Search

Advanced search

Quick links