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prune belly sequence

Wednesday 19 May 2004

Prune belly syndrome or sequence (PBS) is a triad consisting of abdominal musculature hypoplasia, urinary tract malformations, and cryptorchidism. It is frequently associated with other congenital malformations.

The etiology, however, remains uncertain. Theories of mesenchymal maldevelopment, obstruction, and genetic origin have been proposed.


- megacystis
- urinary tract defects
- abdominal muscle deficiency (abdominal wall hypoplasia)
- cryptorchidism


- obstructive form (urethral obstruction sequence)

  • urethral atresia (urethral agenesis)
  • posterior urethral valves
  • meconial urethral obstruction

- non-obstructive form

  • urinary bladder abnormal innervation
  • visceral myopathy
    • megacystis-microcolon-hypoperistalsis syndrome (MMIH syndrome) (MIM.249210)


- pulmonic stenosis, mental retardation, and deafness (MIM.264140)
- digestive anomalies (3537997)

  • gastrointestinal malrotation
  • mesenteric anomalies
  • severe malformations of midgut and hindgut
  • distal digestive stenoses
  • distal digestive atresias
  • postnatal volvulus
  • higher risk for persistence of the common fetal cloaca

See also

- urethral obstruction sequence (UOS)


- Volmar KE, Fritsch MK, Perlman EJ, Hutchins GM. Patterns of congenital lower urinary tract obstructive uropathy: relation to abnormal prostate and bladder development and the prune belly syndrome. Pediatr Dev Pathol. 2001 Sep-Oct;4(5):467-72. PMID: 11779049

- Poucell-Hatton S, Huang M, Bannykh S, Benirschke K, Masliah E. Fetal obstructive uropathy: patterns of renal pathology. Pediatr Dev Pathol. 2000 May-Jun;3(3):223-31. PMID: 10742409

- Popek EJ, Tyson RW, Miller GJ, Caldwell SA. Prostate development in prune belly syndrome (PBS) and posterior urethral valves (PUV): etiology of PBS—lower urinary tract obstruction or primary mesenchymal defect? Pediatr Pathol. 1991 Jan-Feb;11(1):1-29. PMID: 2014185

- Manivel JC, Pettinato G, Reinberg Y, Gonzalez R, Burke B, Dehner LP. Prune belly syndrome: clinicopathologic study of 29 cases. Pediatr Pathol. 1989;9(6):691-711. PMID: 2602227

- Wright JR Jr, Barth RF, Neff JC, Poe ET, Sucheston ME, Stempel LE. Gastrointestinal malformations associated with prune belly syndrome: three cases and a review of the literature. Pediatr Pathol. 1986;5(3-4):421-48. PMID: 3537997