The Question:
The image is a micturating cysto–urethrogram (MCUG) performed (see picture) in an 18–month–old boy who presented with problems of urinary dribbling since birth, with fever, dysuria, straining on micturition and a lower abdominal mass. He had never passed urine with a normal stream. A physical examination revealed a distended bladder and normal genitalia. His serum urea level was 0.85 g/L (normal range 0.05–0.4 g/L) and creatinine level 27 mg/L (normal range 5–15 mg/L). Source: Dr. M. Zia–Ul–Miraj, Lahore Pakistan. BJU International 2000
