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Clinical and urodynamics outcomes in pediatric primary bladder diverticula: a comparative study
Birgül Karaaslan1, Mehmet O Kuzdan1
1Department of Pediatric Surgery, Başakşehir Çam and Sakura Training Hospital, Istanbul, Turkey.
Insights
Bladder diverticula size significantly impacts pediatric bladder function. Larger diverticula (LD) are linked to higher detrusor pressure and urinary tract infections, while smaller diverticula (SD) show better flow rates.
Area of Science:
- Pediatric Urology
- Urodynamics
- Bladder Dysfunction
Background:
- Primary bladder diverticula are congenital anomalies.
- Diverticula size may influence bladder function and clinical outcomes.
Purpose of the Study:
- To compare the effects of small (SD < 30 mm) versus large (LD > 30 mm) bladder diverticula on bladder function and urodynamics in pediatric patients.
Main Methods:
- Retrospective analysis of 40 pediatric patients with primary bladder diverticula.
- Comparison of urodynamic parameters between SD and LD groups.
- Assessment of urinary tract infection (UTI) and upper urinary tract (UUT) dilatation prevalence.
Main Results:
- LD group showed significantly higher mean detrusor pressure (137.2 cm H2O) and UTI rates (p < 0.001).
- SD group exhibited a significantly higher mean peak flow rate (Qmax = 20.7 mL/s) (p < 0.001).
- UUT dilatation was more frequent in the LD group (60%) compared to the SD group (15%) (p = 0.003).
Conclusions:
- Bladder diverticula size is a critical determinant of clinical presentation and management in pediatric patients.
- Urodynamic findings and complication rates differ significantly based on diverticula size.
Objective:
This study aimed to compare the effects of bladder diverticula smaller than 30 (SD) mm and larger than 30 mm (LD) on bladder functions and urodynamics.
Materials And Methods:
Our retrospective analysis involved a cohort of 40 pediatric patients diagnosed with primary bladder diverticula.
Results:
The predicted mean bladder capacity (MBC) was 197.7 ± 95.8 mL, whereas the observed MBC was lower at an average of 170.1 ± 79.6 mL. This indicates that the observed MBC was 88.2 ± 12.9% of the predicted value (percentage). The mean diverticula diameter recorded was 33 ± 19.5 mm, and the diverticula to MBC ratio were calculated to be 0.25 ± 0.18. The distribution of urinary tract infections (UTIs) differed significantly between the groups (p < 0.001). Upper UT dilatation was significantly more common in the LD group (60%, n = 12) than in the SD group (15%, n = 3) (p = 0.003). The mean detrusor pressure (P[detrusor]) was significantly higher in the LD group (137.2 ± 24.1 cm H2O) than in the SD group (63.9 ± 5.8 cm H2O) (p = 0.001). In addition, the mean peak flow rate (Qmax) was significantly higher in the SD group (20.7 ± 7.9 mL/s) compared to the LD group (12.7 ± 3.8 mL/s) (p < 0.001).
Conclusion:
Bladder diverticula size is a significant factor in the clinical presentation and management of primary bladder diverticula in pediatric patients.
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