Posterior urethral valves (PUVs) are the main cause of urethral obstruction in newborns and infants that continues to be a significant cause of morbidity and mortality in pediatric-age patients.1 , 2 In males, children born with bladder obstructive uropathy and renal dysplasia represent the single largest group undergoing renal dialysis and transplantation under 5 years of age. End-stage renal disease develops in a significant proportion, varying from 30% to 42%.1 In 2003, the ItalKid Project, which consists of a prospective population-based registry assessing the epidemiology of chronic renal failure (CRF) in pediatric age on the basis of 1197 patients recruited in 10 years, showed that renal hypodysplasia with identified congenital uropathy was the most common cause of CRF (43.6%): in this group, PUVs were second only to vesicoureteral reflux (VUR), accounting for 23.8%.3