Posterior urethral valve complicated by bilateral urinoma and vesicoureteral reflux

We discuss a case of a late preterm neonate who presented with hematuria and impaired renal function. Antenatally, the baby was diagnosed with bilateral gross hydroureteronephrosis. The postnatal abdominal ultrasound revealed bilateral subcapsular renal collections, mild hydroureteronephrosis, renal parenchymal changes and a cystic lesion around the bladder neck. Micturating cystourethrogram revealed the presence of posterior urethral valve (PUV) and left grade 5 vesicoureteral reflux. A final diagnosis of bilateral subcapsular urinomas due to PUV was made. The patient underwent vesicostomy, which resulted in considerable improvement in renal function. A follow-up ultrasound scan after a few weeks revealed a significant reduction in the size of bilateral urinomas and improvement in renal function.