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This study diagnosed and treated five children suffering from severe bladder distension and hydroureteronephrosis due to excessive urination (polyuria). Causes included various forms of diabetes insipidus and other conditions, with urinary outlet obstruction ruled out.
Area of Science:
- Pediatric Nephrology
- Urology
Background:
- Children can present with significant bladder distension and upper urinary tract dilation.
- Polyuria, or excessive urination, is a key symptom that can lead to these urinary tract changes.
Observation:
- Five pediatric cases with massive bladders and hydroureteronephrosis secondary to polyuria were identified.
- The polyuria stemmed from diverse etiologies including familial nephrogenic diabetes insipidus, medullary cystic disease, central diabetes insipidus from panhypopituitarism, and psychogenic polydipsia.
- 24-hour urine volume measurements confirmed polyuria in all patients.
Findings:
- The study successfully diagnosed and treated these complex pediatric cases.
- Anatomic and physiologic urinary outlet obstruction was definitively excluded through flowmetry, voiding cystourethrography, and endoscopy.
Implications:
- Understanding the diverse causes of polyuria is crucial for diagnosing bladder and hydroureteronephrosis in children.
- Prompt diagnosis and management of polyuria can prevent severe urinary tract complications.
- This highlights the importance of a comprehensive diagnostic approach, ruling out obstruction when investigating polyuria-related uropathy.
Abstract:
We diagnosed and treated 5 children with huge bladders and hydroureteronephrosis secondary to polyuria, resulting from either familial nephrogenic diabetes insipidus, medullary cystic disease, central diabetes insipidus secondary to panhypopituitarism or psychogenic polydipsia. Polyuria was documented by the measurement of 24-hour urine volumes. The possibility of anatomic and physiologic outlet obstruction was eliminated by flowmetry, voiding cystourethrography and endoscopy.