• in males only
• obstructive membranes = backflow of pressure = renal dilatation
• all bilateral (as its a urethral problem)
• epidemiology - between 1 in 5000 and 1 in 8000 babies
• could be a genetic bases,not sure of aetiology, occurs early in faetal development
• significant consequences -
  • 20-65% of children develop CKD in childhood
  • Oligohydramnios - pulmonary hyperplasia, contractures, talipes

Clinical presentation

• distended abdo - big bladder - mass
• prone to UTIs
• weak stream
• urinary frequency
• incontinence after toilet training
• poor weight gain/failure to thrive

Investigations

• Urgent USS of kidneys and renal tract
• check U&E at 24 hrs

Management