Urology: posterior urethral valves management: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Urology: posterior urethral valves management

Sample item

A newborn boy has a weak urinary stream and a palpable bladder. Antenatal ultrasound had shown bilateral hydronephrosis, a thick-walled bladder and a keyhole sign. Creatinine is raised. What is the first step in management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Bladder drainage with a urethral catheter

Posterior urethral valves cause bladder outlet obstruction in boys. The first step is to relieve obstruction by catheter drainage with correction of fluid and electrolyte disturbance. Definitive treatment is endoscopic valve ablation once the infant is stable.

Option by option

  • A. Immediate open excision of the valve

    Open excision is not used because endoscopic ablation is the definitive treatment once stable.

  • B. Bilateral percutaneous nephrostomies

    Nephrostomy is not the first step because the obstruction is at the bladder outlet.

  • C. Bladder drainage with a urethral catheter (correct)

    Correct. Catheter drainage relieves the obstruction and protects the kidneys.

  • D. Bilateral ureteric reimplantation

    Reimplantation deals with reflux and is not the first step.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Bladder drainage with a urethral catheter. Posterior urethral valves cause bladder outlet obstruction in boys.

Why is "Immediate open excision of the valve" not the answer?

Open excision is not used because endoscopic ablation is the definitive treatment once stable.

Why is "Bilateral percutaneous nephrostomies" not the answer?

Nephrostomy is not the first step because the obstruction is at the bladder outlet.

Why is "Bilateral ureteric reimplantation" not the answer?

Reimplantation deals with reflux and is not the first step.

What concept does this question test?

It tests Urology: posterior urethral valves management in General Surgery. The first step is to relieve obstruction by catheter drainage with correction of fluid and electrolyte disturbance. Definitive treatment is endoscopic valve ablation once the infant is stable.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Urology: posterior urethral valves management?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.