Primary congenital bladder diverticula: Where does the ureter drain?

Background: Primary congenital bladder diverticulum (PCBD) is related to a deficient detrusor layer allowing out-pouching of the bladder mucosa through the inadequate muscularis wall. We aimed to review our experience with symptomatic PCBD in order to correlate clinical findings with anatomical aspe...

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Main Authors: Antonio Macedo, Gilmar Garrone, Sérgio Leite Ottoni, Diego Estevam Oliveira, Geórgia Rubiane Meira do Rosário Souza, Marcela Leal da Cruz
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2015-01-01
Series:African Journal of Paediatric Surgery
Subjects:
Online Access:http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2015;volume=12;issue=4;spage=280;epage=285;aulast=Macedo
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author Antonio Macedo
Gilmar Garrone
Sérgio Leite Ottoni
Diego Estevam Oliveira
Geórgia Rubiane Meira do Rosário Souza
Marcela Leal da Cruz
author_facet Antonio Macedo
Gilmar Garrone
Sérgio Leite Ottoni
Diego Estevam Oliveira
Geórgia Rubiane Meira do Rosário Souza
Marcela Leal da Cruz
author_sort Antonio Macedo
collection DOAJ
description Background: Primary congenital bladder diverticulum (PCBD) is related to a deficient detrusor layer allowing out-pouching of the bladder mucosa through the inadequate muscularis wall. We aimed to review our experience with symptomatic PCBD in order to correlate clinical findings with anatomical aspects and to present late outcome. Materials and Methods: We reviewed all patients operated in our institution since 2004. We evaluated the charts for complaints, radiological exams, method of treatment, complications and length of follow-up. Results: We treated 10 cases (11 renal units - [RU]), predominantly males (9/10), mean age at surgery of 5.3 years. All patients had significant urological complaints presenting either with antenatal hydronephrosis (4) or febrile urinary tract infection (5) and urinary retention in one. The ureter was found implanted inside the diverticulum in 8/11 RU. An extravesical psoas-hitch ureteroneocystostomy and diverticulum resection was performed in 10/11 cases, whereas 1 case was treated intravesically based on surgeon′s preference without performing cystoscopy. Mean follow-up was 34.1 months (1-120) without complications. Conclusions: PCBD is an uncommon diagnosis and has a high probability of drainage inside the diverticulum (72.7%). We recommend the extravesical approach associated with diverticulectomy and ureteroneocystostomy as the preferred technique to treat this abnormality.
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spelling doaj.art-00707fac16f140359c3542c472f591e32022-12-21T23:22:36ZengWolters Kluwer Medknow PublicationsAfrican Journal of Paediatric Surgery0189-67250974-59982015-01-0112428028510.4103/0189-6725.172574Primary congenital bladder diverticula: Where does the ureter drain?Antonio MacedoGilmar GarroneSérgio Leite OttoniDiego Estevam OliveiraGeórgia Rubiane Meira do Rosário SouzaMarcela Leal da CruzBackground: Primary congenital bladder diverticulum (PCBD) is related to a deficient detrusor layer allowing out-pouching of the bladder mucosa through the inadequate muscularis wall. We aimed to review our experience with symptomatic PCBD in order to correlate clinical findings with anatomical aspects and to present late outcome. Materials and Methods: We reviewed all patients operated in our institution since 2004. We evaluated the charts for complaints, radiological exams, method of treatment, complications and length of follow-up. Results: We treated 10 cases (11 renal units - [RU]), predominantly males (9/10), mean age at surgery of 5.3 years. All patients had significant urological complaints presenting either with antenatal hydronephrosis (4) or febrile urinary tract infection (5) and urinary retention in one. The ureter was found implanted inside the diverticulum in 8/11 RU. An extravesical psoas-hitch ureteroneocystostomy and diverticulum resection was performed in 10/11 cases, whereas 1 case was treated intravesically based on surgeon′s preference without performing cystoscopy. Mean follow-up was 34.1 months (1-120) without complications. Conclusions: PCBD is an uncommon diagnosis and has a high probability of drainage inside the diverticulum (72.7%). We recommend the extravesical approach associated with diverticulectomy and ureteroneocystostomy as the preferred technique to treat this abnormality.http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2015;volume=12;issue=4;spage=280;epage=285;aulast=MacedoBladderdiverticulainfectionpaediatricvoiding dysfunction
spellingShingle Antonio Macedo
Gilmar Garrone
Sérgio Leite Ottoni
Diego Estevam Oliveira
Geórgia Rubiane Meira do Rosário Souza
Marcela Leal da Cruz
Primary congenital bladder diverticula: Where does the ureter drain?
African Journal of Paediatric Surgery
Bladder
diverticula
infection
paediatric
voiding dysfunction
title Primary congenital bladder diverticula: Where does the ureter drain?
title_full Primary congenital bladder diverticula: Where does the ureter drain?
title_fullStr Primary congenital bladder diverticula: Where does the ureter drain?
title_full_unstemmed Primary congenital bladder diverticula: Where does the ureter drain?
title_short Primary congenital bladder diverticula: Where does the ureter drain?
title_sort primary congenital bladder diverticula where does the ureter drain
topic Bladder
diverticula
infection
paediatric
voiding dysfunction
url http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2015;volume=12;issue=4;spage=280;epage=285;aulast=Macedo
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AT sergioleiteottoni primarycongenitalbladderdiverticulawheredoestheureterdrain
AT diegoestevamoliveira primarycongenitalbladderdiverticulawheredoestheureterdrain
AT georgiarubianemeiradorosariosouza primarycongenitalbladderdiverticulawheredoestheureterdrain
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