DOI: https://doi.org/10.36347/sasjs.2025.v11i07.002

Pages: 772-775

Introduction: Valves of the posterior urethra (VUP) represent one of the main causes of congenital subvesical obstruction in boys. Although usually diagnosed in childhood, in exceptional cases they may remain unrecognised until adulthood, when severe complications reveal them. Case Report: We report the case of a 41-year-old Beninese patient with bulky abdominal distension for 10 years, associated with chronic dysuria and impaired renal function with a GFR of< 15ml/min. Initial assessment of lower urinary tract symptoms revealed an IPSS score of 28/35 with a urinary symptoms-related quality of life score of (6/6), indicating severe symptoms. An injected abdominal-pelvic CT scan revealed major bilateral ureterohydronephrosis, predominantly on the left. Diagnostic cystoscopy revealed evidence of a valve in the posterior urethra, which was treated by endoscopic resection. The postoperative course was favourable, with normalisation of renal function and a spectacular improvement in the IPSS score to 5/35 (urinary symptoms-related quality of life score 1/6) at follow-up at 1 week, 1 month, 3 months, 6 months and 10 months. Conclusion: This case illustrates the frequent delay in diagnosing posterior urethral valves (PUV) in underdeveloped countries and highlights the importance of including this condition in the differential diagnosis of abdominal masses and chronic dysuria in young adults. The use of low-cost tools, such as standardised scores like the IPSS, together with access to a cystoscope and an endoscopic resector, can not only help prevent serious complications like a renal failure but also objectify the effectiveness of treatment and improve patient follow-up. Despite the relative simplicity of endoscopic treatment, early diagnosis remains essential to preserve long-term renal function.