[Congenital bladder diverticula in children. Report of four cases]

Abstract: The conginital bladder diverticulum is related to a weakness in the bladder musculature especially in the para-hiatal region. It is mostly asmptomatic but in some cases it may produce urinary tract infection or urinary retention. We present our experience with the management of congenital bladder diverticula in infants

Materials and Methods: The authors report a series of 4 patients treated from 1994 to 2003, for congenital bladder diverticulum in the department of surgery B at the children's hospital of Tunis. The diagnosis was established in three cases on recurrent urinary tract infection and in the fourth case on urinary retention. A bilateral vesicoureteral reflux was found in one patient and an intradiverticular stone in another one. Surgical treatment with excision of the diverticulum was undertaken in all patients

Results: After surgical treatment none of the patients has had reccurrence of the diverticulum, and all remain asymptomatic

Conclusion: Congenital bladder diveticulum has a wide clinical spectrum. Urinary tract infection and urinary retention are the most frequent presentation forms. The surgical treatment is indicated in all symptomatic cases

[Pathogen complete ureteric duplication in children. A 20 cases report]

Duplex System is a relatively rare malformative uropathy. It represents 0.2% of general population, with 15 to 25% of pathogen forms. A retrospective study of 20 cases, reported in 12 years is presented. Patient's age at diagnosis varied between 10 days and 10 years [mean age: 47.5 months]. Feminine predominance was noted, with a sex-ratio of 0.42. Clinical features were dominated by urinary infection [65% of cases]. Antenatal diagnosis represented 25% of cases. Diagnosis was confirmed by ultrasound, intravenous urography, cystography and cystoscopy. We noted a vesico-ureteral ref lux in the lower pole in 15 cases, 9 ureteroceles and two ectopic ureteral implantation. Conservative treatment was endoscopic in 5 cases of vesico-ureteral reflux and surgical [reimplantation +/- ureterocele excision] in 10 patients. An upper pole nephrectomy was done in 8 cases and a lower pole nephrectomy in 1 case. Outcome was uneventful in all cases. Ureteric duplication is complex with prognosis depending essentially on early diagnosis and the degree of renal parenchyma damage