A 1-month-old male infant is referred to the pediatric urology clinic due to poor feeding, irritability, and signs of urinary retention. His parents report that he has had difficulty urinating since birth, with a weak urine stream and frequent dribbling. Additionally, they notice that his abdomen appears slightly distended, and he has been crying excessively during diaper changes, especially when urinating.

On physical examination, the baby is mildly dehydrated, and the lower abdomen is slightly distended. There are no signs of fever or infection. A renal ultrasound is performed, revealing moderate bilateral hydronephrosis, suggesting an obstruction in the urinary tract. To further investigate, a voiding cystourethrogram (VCUG) is ordered, which shows a classic "keyhole" appearance of the bladder due to the presence of congenital urethral valves. This condition involves the formation of abnormal flaps of tissue within the urethra that obstruct urine flow, leading to urinary retention and backpressure on the kidneys.

The diagnosis of congenital urethral valves is confirmed, and the baby is referred for surgical intervention, which typically involves valve ablation or resection. The pediatric urologist explains the condition to the parents and discusses the need for surgery to prevent further renal damage and improve urinary function. A follow-up plan is established to monitor the baby's progress post-surgery and ensure normal kidney function.