Abstract
Purpose
Congenital primary bladder diverticulum is a rare condition and may present with urinary infection; other forms of presentation are rare. We present a series of infants who presented with urinary retention secondary to large primary bladder diverticulum.
Methods
Seven infants were evaluated for symptoms of lower urinary tract obstruction. All seven were infant boys; three were neonates. Investigations included ultrasonogram, voiding cystourethrogram (VCUG) and cystoscopy.
Results
Six infants had single large diverticulum while one had bilateral diverticula. VCUG was diagnostic in all cases demonstrating the mechanism of obstruction clearly except one where bilateral diverticula was diagnosed only on cystoscopy prior to definitive surgery. Five children (including one neonate) underwent successful definitive repair consisting of diverticulectomy and ureteral re-implant while two neonates were planned for a staged correction. One neonate later in the series underwent definitive primary repair as bladder was good sized. All five children have done well after definitive repair at a follow-up of 6–72 months.
Conclusion
Primary bladder diverticulum in infants may present with lower urinary obstructive symptoms indistinguishable from posterior urethral valves. A carefully done VCUG can help in diagnosis. Primary definitive repair can be undertaken even in first few months of life with good results.
Similar content being viewed by others
References
Pieretti RV, Pieretti-Vanmarcke RV (1999) Congenital bladder diverticula in children. J Pediatr Surg 34:468–473
Sheldon CA, Essig KA (1994) Congenital bladder diverticulum causing bladder outlet obstruction: a case report and review of the literature. Pediatr Surg Int 9:141–143
Stephens FD (1979) The vesicoureteral hiatus and paraureteral diverticula. J Urol 121:786–791
Zia-ul-Miraj M (1999) Congenital bladder diverticulum: a rare cause of bladder outlet obstruction in children. J Urol 162:2112
Öge Ö, Gemalmaz H, Özeren B (2002) Acute urinary retention in a child caused by a congenital bladder diverticulum. J Pediatr Surg 37:926–927
Verghese M, Belman BA (1984) Urinary retention secondary to bladder diverticula in infants. J Urol 132:1186–1188
Shukla AR, Bellah RA, Canning DA, Carr MC, Snyder HM, Zderic SA (2004) Giant bladder diverticula causing bladder outlet obstruction in children. J Urol 172:1977–1979
Evangelidis A, Castle EP, Ostlie DJ, Snyder CL, Gatti JM, Murphy JP (2005) Surgical management of primary bladder diverticula in children. J Pediatr Surg 40:701–703
Bogdanos J, Paleodimos I, Korakianitis G, Stephanidis A, Androulakakis PA (2005) The large bladder diverticulum in children. J Pediatr Urol 1:267–272
Garat JM, Angerri O, Caffaratti J, Moscateillo P, Villavicentio H (2007) Primary congenital bladder diverticula in children. Urology 70:984–988
Kelalis PP (1976) Obstructive uropathy: bladder. In: Kelalis PP, King LR (eds) Clinical pediatric urology, 1st edn. Saunders, Philadelphia, pp 282–291
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Singal, A.K., Chandrasekharam, V.V.S.S. Lower urinary tract obstruction secondary to congenital bladder diverticula in infants. Pediatr Surg Int 25, 1117–1121 (2009). https://doi.org/10.1007/s00383-009-2470-3
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00383-009-2470-3