Giant bladder diverticula causing bladder outlet obstruction in children

被引:27
|
作者
Shukla, AR
Bellah, RA
Canning, DA
Carr, MC
Snyder, HM
Zderic, SA
机构
[1] Childrens Hosp Philadelphia, Div Pediat Urol, Philadelphia, PA 19104 USA
[2] Childrens Hosp Philadelphia, Div Pediat Radiol, Philadelphia, PA 19104 USA
来源
JOURNAL OF UROLOGY | 2004年 / 172卷 / 05期
关键词
bladder diseases; diverticulum; bladder neck obstruction; Ehlers-Danlos syndrome;
D O I
10.1097/01.ju.0000140450.50242.50
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose: Congenital giant diverticulum of the bladder is a consequence of deficiency in the detrusor musculature and has been reported in male infants as a rare cause of bladder outlet obstruction. Materials and Methods: A 10-year retrospective review revealed 4 patients (3 boys and 1 girl) with bladder outlet obstruction due to a giant bladder diverticulum. Prenatal and postnatal clinical and imaging records were reviewed. Results: Prenatal sonography was unremarkable in all patients. Three males (ages 4 months, 10 months and 3 years) had no medical history of voiding dysfunction, and 1 female (11 years) had the Ehlers-Danlos syndrome. While the girl presented with urinary tract infection, all patients presented with progressively decreasing urinary stream and urinary retention. Each patient underwent voiding cystourethrography (VCUG) and ultrasound. In each patient VCUG showed a giant (greater than 7 cm) bladder diverticulum that descended below the bladder neck and compressed the urethra during voiding. Vesicoureteral reflux was seen in 2 patients. Ultrasonography demonstrated moderate unilateral hydronephrosis in 2 patients. Bladder diverticulectomy was successfully performed in all patients, with ureteral reimplantation in 3. Conclusions: A giant congenital bladder diverticulum, when noted on VCUG to descend below the bladder neck, may lead to bladder outlet obstruction. To our knowledge we report the first case of a female presenting with bladder outlet obstruction due to a giant bladder diverticulum. Children with connective tissue disorders may be predisposed to this disorder, which must be excluded, regardless of gender, in all patients presenting with voiding abnormalities. Surgical diverticulectomy, often with ureteral reimplantation, is the preferred treatment, with excellent long-term results.
引用
收藏
页码:1977 / 1979
页数:3
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