Congenital obstructive posterior urethral membranes and recurrent urinary tract infection: a rare case of congenital hypertrophy of the verumontanum

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Diana Bancin
Elisabeth S. Herini
Pungky Ardani Kusuma
Neti Nurani


Congenital obstructive posterior urethral membranes (COPUM) is a complex disease closely related to several pathological changes in kidney development and function, as a result of urinary reflux since in utero. This congenital anomaly of urinary tract potentially causes hydroureteronephrosis that is often associated with recurrent urinary tract infections and, ultimately, one of the most common causes of end-stage renal disease in children.1,2 Congenital hypertrophy of the verumontanum as part of COPUM is very rare. Only a few reports have been written on congenital hypertrophy of the vermontanum causing congenital obstructive uropathy.3-6

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Bancin D, Herini ES, Kusuma PA, Nurani N. Congenital obstructive posterior urethral membranes and recurrent urinary tract infection: a rare case of congenital hypertrophy of the verumontanum. PI [Internet]. 1Mar.2015 [cited 24Apr.2019];55(1):59-4. Available from:


1. Ansari MS, Singh P, Mandani A, Dubey D, Srivatava A, Kapoor R, et al. Delayed presentation posterior urethral valve: long-term implications and outcome. Urology. 2008;71:230-4.
2. Sanna-Cherchi S, Ravani P, Corbani V, Parodi S, Haupt R, Piaggio G, et al. Renal outcome in patients with congenital anomalies of the kidney and urinary tract. Kidney Int. 2009;76:528–33.
3. Bapna BC, Reddy AV, Wadhwa SN. Hypertrophied verumontanum producing urinary obstruction. Indian J Pediatr. 1970;37:155-7.
4. Ohkawa T, Nakamura M. Congenital hypertrophy of the verumontanum: report of a case. Hinyokika Kiyo. 1963;9:321-5.
5. Kilciler M, Soydan H, Ozgok Y, Erduran D, Harmankaya C. A rare cause of urethral obstruction: verumontanum attachment. J Urol. 2001;166:1401-3.
6. Baldridge, RR. A case of congenital hypertrophy of the verumontanum. N Engl J Med. 1935;213:46-9.
7. Alatas H. Gagal ginjal akut. In: Noer MS, Soemyarso NA, Subandiyah K, Prasetyo RV, Alatas H, Tambunan T, et al., editors. Kompendium Nefrologi Anak. Jakarta: Badan penerbit IDAI; 2011. p. 207-22.
8. Woodward M, Frank D. Postnatal management of antenatal hydronephrosis. BJU Int. 2002;89:149–56.
9. Stefan C, Bulucea D. Urinary tract infection and urological abnormalities in children. Acta Medica Marisiensis. 2009;363-5.
10. Honkinen O, Jahnukainen T, Mertsola J, Eskola J, Ruuskanen O. Bacteremic urinary tract infection in children. Pediatric Infect Dis J. 2000;19:630-4.
11. Ladhani S, Gransden W. Increasing antibiotic resistance among urinary tract isolates. Arch Dis Child. 2003;88:444–5.
12. Chang SL, Shortliffe LD. Pediatric urinary tract infections. Pediatr Clin North Am. 2006;53:379-400.
13. McKerrow W, Davidson-Lamb N, Jones PF. Urinary tract infection in children. Br Med J. 1984;289:299-303.
14. Najib KH, Fallahzadeh E, Fallahzadeh MK, Erjanee A. Renal scar formation in children with recurrent urinary tract infections. Iranian Red Crescent Med J. 2009;11:93-95. 15. Jakobsson B, Berg U, Svensson L. Renal scarring after acute pyelonephritis. Arch Dis Child. 1994;70:111-5.
16. Orellana P, Baquedano P, Rangarajan V, Zhao JH, Eng ND, Fettich J, et al. Relationship between acute pyelonephritis, renal scarring, and vesicoureteral reflux. Results of a coordinated research project. Pediatr Nephrol. 2004;19:1122-6.
17. Jacobson SH, Eklof O, Eriksson CG, Lins LE, Tidgren B, Winberg J. Development of hypertension and uraemia after pyelonephritis in childhood: 27 year follow up. BMJ. 1989;299:703-6.
18. Sarhan O, El-Ghoneimi A, Hafez A, Dawaba M, Ghali A, Ibrahiem el-H. Surgical complications of posterior urethral valve ablation: 20 years experience. J Pediatr Surg. 2010;45:2222-6.
19. Downs SM. Technical report: urinary tract infections in febrile infants and young children. The Urinary Tract Subcommittee of the American Academy of Pediatrics Committee on Quality Improvement. Pediatrics. 1999;103:1-60.
20. Smellie JM, Normand IC, Katz G. Children with urinary infection: a comparison of those with and without vesicoureteric reflux. Kidney Int. 1981;20:717-22.
21. Uthup S, Binitha R, Geetha S, Hema R, Kailas L. A follow up study of children with posterior urethral valve. Indian J Nephrol. 2010;20:72-5.
22. Garin EH, Olavarria F, Garcia Nieto V, Valenciano B, Campos A, Young L. Clinical significance of primary vesicoureteral reflux and urinary antibiotic prophylaxis after acute pyelonephritis: a multicenter, randomized, controlled study.Pediatrics. 2006;117:626-32.
23. Conway PH, Cnaan A, Zaoutis T, Henry BV, Grundmeier, Keren R. Recurrent urinary tract infections in children: risk factors and association with prophylactic antimicrobials. JAMA. 2007;298:179-86.
24. American Academy of Pediatrics. Committee on Quality Improvement. Subcommittee on Urinary Tract Infection. Practice parameter: the diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants and young children. Pediatrics. 1999;103:843-52.
25. Shortliffe LM. Urinary tract infection in infants and children. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Campbell-Walsh Urology. 9th ed. Philadelphia: WB Saunders; 2007. p. 1846–84.
26. Nagler EV, Williams G, Hodson EM, Craig JC. Interventions for primary vesicoureteric reflux. Cochrane Database Syst Rev. 2011;6:1-95.
27. Lopez Pereira P, Espinosa L, Martinez Urrutina MJ, Lobato R, Navarro M, Jaureguizar E. Posterior urethral valves: prognostic factors. BJU Int. 2003;91:687-90.
28. Denes ED, Barthold JS, Gonzalez RE. Early prognostic value of serum creatinine levels in children with posterior urethral valves. J Urol. 1997;157:1441–3.
29. Onuora VC, Mirza K, Koko AH, Al Turki M, Meabed AH, Al Jawini N. Prognostic factors in Saudi children with posterior urethral valves. Pediatr Nephrol. 2000;14:221–3.