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Bladder dysfunction: an integral part of the ectopic ureterocele complex
K Abrahamsson1, E Hansson, U Sillén
1Department of Pediatric Surgery, Ostra Hospital, Göteborg, Sweden.
Insights
Children with ectopic ureterocele often experience bladder dysfunction, including high bladder capacity and incomplete emptying. This dysfunction appears to be an inherent part of the condition, not caused by surgical intervention.
Area of Science:
- Pediatric Urology
- Urodynamics
- Congenital Anomalies
Background:
- Ectopic ureteroceles are congenital anomalies that can lead to urinary tract issues.
- The relationship between ectopic ureteroceles and bladder dysfunction requires further investigation.
Purpose of the Study:
- To determine the prevalence of bladder dysfunction in patients with ectopic ureterocele.
- To ascertain if bladder dysfunction is an intrinsic component of the ectopic ureterocele complex or a postsurgical complication.
Main Methods:
- Retrospective analysis of 34 patients treated for ectopic ureteroceles (1986-1995).
- Postoperative evaluation of bladder function in 32 patients using history, uroflowmetry, ultrasound for residual urine, and cystometry.
Main Results:
- 19 of 32 patients reported infrequent voiding; 3 experienced incontinence.
- 55% of patients had increased bladder capacity ( >150% of age-predicted normal).
- 56% of patients had significant residual urine (>5 ml) on uroflowmetry; no bladder neck obstruction found postoperatively.
Conclusions:
- Children with ectopic ureterocele exhibit a high incidence of high-capacity bladders with incomplete emptying.
- Bladder dysfunction is likely an integral part of the ectopic ureterocele disorder, not a consequence of surgical treatment.
Purpose:
We evaluate whether bladder dysfunction is common in patients with ectopic ureterocele and, if so, whether it is an integral part of the ectopic ureterocele complex or a result of surgery.
Materials And Methods:
From 1986 to 1995, 34 patients with a mean age of 10 months were treated for large or medium ectopic ureteroceles at our institution and 32 participated in postoperative followup. Bladder function was investigated by a careful history and repeat uroflowmetry, and residual urine estimation was assessed by ultrasound and cystometry.
Results:
Of the 32 patients 19 had infrequent voiding and 3 had incontinence. Cystometric bladder capacity was increased to greater than 150% of the normal value for age in 15 of 27 patients (55%). Uroflowmetry revealed greater than 5 ml. residual urine in 15 patients (56%). Postoperatively no radiological signs of bladder neck obstruction were found. Increased bladder capacity and residual urine did not correlate with ureterocele size or location, or surgical procedure. There was no progression of bladder dysfunction with age.
Conclusions:
Children with ectopic ureterocele are at high risk for a high capacity bladder with incomplete emptying. This bladder dysfunction associated with ectopic ureterocele does not seem to be the result of surgery but an integral part of the disorder.