Congenital bladder obstruction

Congenital bladder obstruction, usually due to posterior urethral valves, may have long-lasting and profound renal and bladder consequences, yet may be of gradual onset. The importance of early recognition, as well as the realization that bladder dysfunction is the basis of associated hydronephrosis, reflux, or incontinence, is emphasized. The authors describe the range of clinical presentations and their appropriate evaluation, as well as treatment approaches. The medical and surgical alternatives include anticholinergic bladder therapy and augmentation cystoplasty. The relative advantages and disadvantages of these alternatives are discussed, and a brief review of future research prospects also is included.