Bladder neck obstruction in children. 46 cases

Abstract

The possible diagnosis of ‘maladie du col vesical’ has been made on 46 children. This bladder-neck obstruction was not secondary (no intracervical obstruction). All the diagnostic criteria are reviewed: post-micturition residual, bladder trabeculations and diverticulum, endoscopic aspect of the neck, during micturating cystourethrogram and transvesical operation, pathology of the bladder-neck. None of the criteria is absolutely certain in proving bladder-neck obstruction. The review of literature on this subject is also very confusing. The results of treatment are difficult to evaluate because reimplantation of the ureter(s) has often been done at the same time. The resection of the posterior lip of the Y–V plasty done without ureterocystoneostomy, never eliminate vesicoureteral reflux or improves the upper urinary tract. Several post-operative complications (urinary incontinence, epididymitis) have been seen and aggravate the pronostic. The ‘maladie du col vesical’ seems to be a rare disease. It is difficult to make the diagnostic and the treatment is not without danger.