Congenital Bladder and Urethral Agenesis: Two Case Reports and Management

Area of Science:

• Pediatric Surgery
• Urology
• Congenital Anomalies

Background:

• Agenesis of the bladder and urethra is an extremely rare congenital anomaly.
• Few living cases of bladder and urethral agenesis have been documented.
• This study focuses on two pediatric patients presenting with urinary incontinence due to this condition.

Purpose of the Study:

• To report two cases of bladder and urethral agenesis in female pediatric patients.
• To describe a novel surgical approach for reconstructing the urinary tract in patients with bladder agenesis.
• To evaluate the efficacy and safety of neobladder creation using the cecum and ascending colon.

Main Methods:

• Two female patients, aged 3 and 6 years, with diagnosed bladder and urethral agenesis underwent surgical intervention.
• Magnetic resonance imaging (MRI) confirmed agenesis and normal ureteric drainage into the vagina.
• A neobladder was constructed from the cecum and ascending colon, with ureters anastomosed in a nonrefluxing manner.
• The appendix was utilized as a continent catheterizable conduit.

Main Results:

• Both patients achieved urinary continence following the neobladder and conduit creation surgery.
• Postoperative follow-up of one year revealed no complications.
• The surgical technique successfully restored urinary function in patients with severe congenital urinary tract anomalies.

Conclusions:

• This study reports the first instance of neobladder creation using the cecum and ascending colon for bladder agenesis.
• The described surgical method offers a viable solution for managing bladder and urethral agenesis.
• The long-term efficacy and safety of this reconstructive approach were demonstrated through a one-year follow-up.