Large congenital bladder diverticula in children

Abstract

Objective: Large congenital bladder diverticula (LCBD), congenital bladder diverticula (CBD) larger than 2 cm diameter, is a rare anomaly. The aim of this study was to report long-term surgical and clinical outcomes of children with LCBD. Methods: Medical charts of all children who were diagnosed with LCBD at our institution between April 2005 and December 2017, with at least 2 year follow-up were retrospectively reviewed. Patients’ demographics, symptoms, operative technique, diverticulum size and localization, surgical outcomes and complications were recorded. Results: Fourteen patients with 18 LCBD, all male and age between 7 and 240 months (mean age: 53.5 months) were included in the study. Urinary tract infection was the main complaint in 10. Vesicoureteral reflux was detected in eight patients. Diverticula were 2–5.5 cm (mean 3.3 cm) in size. All diverticulectomies were performed transvesically and ureteroneocystostomy was added in 12 patients, 5 of whom were bilateral. No postoperative infection or recurrent reflux were observed. The median follow-up period was 4.5 years (2–12 years). Conclusion: Treatment of LCBD is mostly surgical and transvesical approach for diverticulectomy was found to be a safe and effective surgical procedure in long term follow-up.

Resultados clínicos y urodinámicos en divertículos vesicales primarios pediátricos: un estudio comparativo

“…Our findings also demonstrated that patients with larger diverticula had significantly higher rates of upper UT dilatation and vesicoureteral reflux. Previous research has indicated that larger bladder diverticula can cause bladder outlet obstruction, which leads to increased intravesical pressure and can contribute to the development of upper UT dilatation and vesicoureteral reflux 5,10,11 . This further underscores the importance of bladder diverticula size in clinical outcomes.…”

“…Hutch diverticula cause significant vesicoureteral reflux because they distort the ureterovesical junction 4,5 . Primary congenital diverticula have been linked to the connective tissue disorders known as Ehlers-Danlos types IV, V, and IX, which are said to cause the diverticula to rupture spontaneously 6,7 .…”