True statement (s) about posterior urethral valves in neonate
**Core Concept**
Posterior urethral valves (PUV) are congenital obstructions of the urethra in male infants, resulting from abnormal folds of tissue. This condition leads to urinary retention, obstructive uropathy, and potential renal damage.
**Why the Correct Answer is Right**
The presence of PUV causes a significant obstruction to urine flow, leading to increased intravesical pressure and subsequent renal damage. This can result in hydronephrosis, renal scarring, and eventually, end-stage renal disease. The diagnosis of PUV is often made through a combination of clinical presentation, ultrasound findings, and voiding cystourethrogram (VCUG).
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because PUV typically presents with obstructive uropathy, not reflux nephropathy. While both conditions can lead to renal damage, the underlying pathophysiology is different.
**Option B:** This option is incorrect because PUV is not associated with an increased risk of bladder neck obstruction. Instead, it is characterized by a congenital obstruction of the posterior urethra.
**Option C:** This option is incorrect because PUV is not typically associated with an increased risk of cloacal malformation. While both conditions can present with urinary obstruction, they have distinct embryological origins.
**Clinical Pearl / High-Yield Fact**
The presence of PUV is often suggested by the "triad of symptoms": urinary retention, abdominal distension, and failure to thrive. A high index of suspicion is essential in diagnosing this condition, as early intervention can significantly improve outcomes.
**Correct Answer: D.**