مولود ذكر عمره يومان، كان عنده تضخم في الكليتين في أشعة الحمل. تلاحظ الممرضة أن بوله يخرج نقطاً بضعف، والمثانة محسوسة فوق العانة، وكمية البول قليلة. الضغط طبيعي. ماذا يشك الفريق؟

A 2-day-old boy had enlarged kidneys on antenatal scans. The nurse notes a weak dribbling urine stream, a palpable bladder above the pubis and low urine output. BP is normal. What does the team suspect?

1. Normal newborn voiding in the first week
2. Nappy allergy causing low urine output
3. Bladder infection caused by vaginal delivery
4. Posterior urethral valves obstructing urine outflow

Answer: D) Posterior urethral valves obstructing urine outflow. Posterior urethral valves are an important cause of outflow obstruction in boys, presenting with antenatal hydronephrosis, a weak stream and a full bladder; catheterisation and urgent intervention protect the kidneys.