Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with [poor urinary stream / dribbling / abdominal distension / failure to thrive]. History significant for prenatal ultrasound findings of bilateral hydroureteronephrosis and thickened bladder wall. No history of UTI or febrile illness.
Clinical Examination Findings
Abdomen: Palpable bladder (distended), possible bilateral flank masses (hydronephrosis). Genitourinary: Weak, intermittent urinary stream, phimosis may be present. General: Signs of uremia or respiratory distress if pulmonary hypoplasia is present.
Treatment Protocol
Immediate management: Urinary decompression via urethral catheterization. Surgical intervention: Primary endoscopic valve ablation (fulguration). Long-term: Serial monitoring of renal function (Cr, BUN), renal ultrasound, and VCUG to assess for vesicoureteral reflux.