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Keyhole urinary bladder

Case contributed by: Dr Prashant Gupta

Presentation:

Routine antenatal scan at 20 weeks

Patient Data:

Age: 20 wks gestation
Gender: Female
Race: Indian/Pakistani
From the case: Keyhole urinary bladder
Modality: Ultrasound

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  • dilated urinary bladder (green arrow) and posterior urethra(red arrow)
dilated urinary bladder (green arrow) and posterior urethra(red arrow)

Dilated bladder and posterior urethra resulting in a "keyhole" appearance .

Case Discussion:

The keyhole sign of a dilated bladder and posterior urethra suggests a diagnosis of posterior urethral valves, the hydronephrosis is probably due to reflux.

Although antenatal shunt placement is performed it's effectiveness is controversial.

References:

  1. Salam MA. Posterior urethral valve: Outcome of antenatal intervention. Int. J. Urol. 2006;13 (10): 1317-22. doi:10.1111/j.1442-2042.2006.01555.x - Pubmed citation
  2. López pereira P, Martinez urrutia MJ, Jaureguizar E. Initial and long-term management of posterior urethral valves. World J Urol. 2004;22 (6): 418-24. doi:10.1007/s00345-004-0460-6 - Pubmed citation

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