A 13 years old boy presented with acute painful retention of urine at night (it was actually an acute-on-chronic retention, as it came to light later) and since catheterization could not be done due to the tightly stenosed preputial opening, the bladder was emptied with a suprapubic needle. An ultrasound scan in the morning reported circumferential wall thickening of the urinary bladder and a V-shaped deformity of the bladder neck, suggesting a diagnosis of posterior urethral valves.

Paediatric surgical consultation was obtained and an MCU was suggested. This was done and suggested a diagnosis of neurogenic bladder while ruling out posterior urethral valves.

A routine circumcision was performed the same day and the child remains well thereafter.