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Giant bladder diverticula causing bladder outlet obstruction in children

Aseem R Shukla1, Richard A Bellah, Douglas A Canning

  • 1Division of Pediatric Urology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104-4399, USA.

The Journal of Urology
|November 16, 2004
PubMed

Insights

Giant bladder diverticulum, a rare condition causing bladder outlet obstruction, can occur in infants and children. This study highlights a unique female case and emphasizes surgical diverticulectomy as the effective treatment.

Area of Science:

  • Pediatric Urology
  • Congenital Abnormalities
  • Bladder Outlet Obstruction

Background:

  • Congenital giant bladder diverticulum is a rare cause of bladder outlet obstruction in male infants, stemming from detrusor muscle deficiency.
  • This condition can lead to significant voiding abnormalities.

Purpose of the Study:

  • To investigate bladder outlet obstruction caused by congenital giant bladder diverticulum.
  • To report the first known case of a female patient with this condition.

Main Methods:

  • A 10-year retrospective review of 4 patients (3 male, 1 female) with bladder outlet obstruction due to giant bladder diverticulum.
  • Analysis of prenatal and postnatal clinical and imaging records, including voiding cystourethrography (VCUG) and ultrasound.

Main Results:

  • All patients presented with decreased urinary stream and retention; the female patient had Ehlers-Danlos syndrome and urinary tract infection.
  • VCUG revealed giant bladder diverticula ( >7 cm) compressing the urethra during voiding in all patients.
  • Two patients had vesicoureteral reflux and two had unilateral hydronephrosis; all underwent successful bladder diverticulectomy, with 3 requiring ureteral reimplantation.

Conclusions:

  • Giant congenital bladder diverticulum descending below the bladder neck is a cause of bladder outlet obstruction.
  • This study reports the first female case, suggesting connective tissue disorders may predispose patients.
  • Surgical diverticulectomy, with or without ureteral reimplantation, is the recommended treatment for this condition.
Abstract

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