[Bladder neck sclerosis in children]

Nowadays there are contradictory opinions of the prevalence of urinary cervicovesical sclerosis in children and therefore the high incidence of the disease is explained by some investigators as hyperdiagnosis. This article presents the results of examination performed in 15 children with urinary cervicovesical sclerosis who were referred to hospital for other diagnoses. Morphological examination, including electron microscopy, failed to demonstrate the congenital origin of the disease. The authors suspect that the development of cervicovesical sclerosis in children was associated with some secondary reasons. Clinical signs of the disease are characteristic of intravesical obstruction confirmed by uroflow, profilo- and cystomanometries. The findings failed to confirm the dysfunction of the detrusor. In general, cystoscopic examination documented a heterogeneous, more commonly mosaic picture which was not infrequent in the presence of chronic inflammation. Trabecularism of the mucosa was documented in all examinees, false diverticula in four of them. When the irrigation liquid passed the neck of the urinary bladder the latter opened but the stricture was not continuous. X-ray examination revealed the rigidity, compression and high position of lower cervical segments. Cervicovesical sclerosis was treated by transurethral [correction of transureteral] electroresection with a subsequent multiple urodynamic study which proved the correctness in the choice of the treatment policy and its beneficial impact. In case of a "dry urinary bladder', the authors first made operative corrections for the recovery of the urine passage, followed by transurethral [correction of transureteral] electroresection of the neck of the urinary bladder.