Related Experiment Videos
Bladder diverticula in children - a clinical, radiologic and endoscopic study
The International Journal of Pediatric Nephrology
|September 1, 1982
Summary
Bladder diverticula and pouches in children can cause urinary tract infections and hematuria. Long-term follow-up shows these protrusions may develop into diverticula, potentially leading to further urinary tract abnormalities.
Area of Science:
- Pediatric Urology
- Urologic Imaging
- Pediatric Gastroenterology
Background:
- Bladder diverticula and posterolateral pouches are congenital or acquired abnormalities of the bladder wall.
- These conditions can present with various symptoms, including urinary tract infections (UTIs) and hematuria.
- Understanding their natural history and association with other urinary tract abnormalities is crucial for diagnosis and management.
Purpose of the Study:
- To describe the clinical, radiologic, and endoscopic findings in children with bladder diverticula and posterolateral bladder wall protrusions.
- To investigate the association between these bladder abnormalities and lower urinary tract obstruction or vesicoureteral reflux.
- To evaluate the long-term evolution of bladder wall protrusions and their potential to develop into true diverticula.
Main Methods:
- Retrospective review of clinical data, imaging (radiologic), and cystoscopic findings in 93 children (84 with bladder diverticula, 9 with posterolateral pouches).
- Classification of bladder diverticula based on presence or absence of lower urinary tract obstruction.
- Assessment of vesicoureteral reflux (VUR) in relation to diverticula size, obstruction, and pouch morphology.
Main Results:
- A novel 'walnutshell-like' bladder diverticulum was described cystoscopically.
- Urinary tract infections were the most common symptom; hematuria was frequent with walnutshell-like diverticula.
- Of 84 children with bladder diverticula, 66 had no obstruction; 18 had obstruction-related diverticula. Vesicoureteral reflux was present in 34/66 (51.5%) of non-obstructed diverticula cases and 8/9 (88.9%) of posterolateral pouches.
- Saccules (diverticula < 2 cm) were noted in 20 of the non-obstructed diverticula cases with VUR.
Conclusions:
- Any bladder wall protrusion, irrespective of size or opening, can evolve into a diverticulum associated with other urinary tract abnormalities.
- Posterolateral pouches can transform into true diverticula, potentially leading to the development of vesicoureteral reflux.
- Early identification and monitoring of bladder wall protrusions are important in pediatric urology to prevent complications.