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The wide bladder neck and posterior urethra in childhood
Insights
Anomalies of the bladder and urethra in children can cause recurrent urinary tract infections. Management includes long-term urinary disinfection and hygiene, with symptoms often resolving by menarche.
Area of Science:
- Pediatric Nephrology
- Urology
- Pediatric Urology
Background:
- Recurrent urinary tract infections (UTIs) and micturition disorders in children are often linked to bladder and urethral anomalies.
- A wide bladder neck and posterior urethra are identified as potential contributing factors.
Purpose of the Study:
- To examine the role of bladder and urethral anomalies in pediatric recurrent UTIs and micturition disorders.
- To review evidence and present clinical observations on these conditions.
Main Methods:
- Review of published evidence.
- Analysis of data from 300 children with wide bladder neck and posterior urethra, followed at a pediatric nephrology clinic.
- Assessment of functional etiology, including congenital neurogenic or myogenic defects.
Main Results:
- A wide bladder neck and posterior urethra are considered functional anomalies, likely due to congenital defects.
- Long-term urinary disinfection and external meatus hygiene are recommended for managing recurrent ascending infections.
- Symptoms are anticipated to resolve spontaneously around menarche.
Conclusions:
- Bladder and urethral anomalies play a role in recurrent UTIs and micturition issues in children.
- Effective management involves long-term disinfection and hygiene, with a favorable prognosis for spontaneous resolution.
- Close nephrologic follow-up is crucial for affected children.
Abstract:
Involvement of anomalies of the bladder and urethra in recurrent urinary tract infections and micturition disorders in children are examined in the light of published evidence and of the authors' own observations. The data of 300 children followed up for a wide bladder neck and posterior urethra at the Nephrology Clinic of Heim Pál Children's Hospital, Budapest, are reviewed. The dilatation in question is regarded as functional, attributable to a congenital neurogenic or myogenic defect. For the management and prevention of the recurrent ascending infections long-term urinary disinfection and meticulous toilet of the external meatus are recommended. The symptoms are expected to subside spontaneously at the age of menarche. The importance of a close nephrologic follow-up is emphasized.