Urinary bladder outlet obstruction in children.

Abstract

Bladder outlet obstruction, either functionally or structurally, could lead to bladder trabeculation, vesicoureteric reflux, hydronephrosis and, eventually, to renal parenchymal damage. If no treatment is given, end-stage renal failure will ensue. The cases of 17 patients of bladder outlet obstruction at National Taiwan University Hospital from 1984 to 1997 were reviewed. Initial presentation, etiology and treatment were discussed. Nine patients were victims of neurogenic bladder and two patients were victims of nonneurogenic neurogenic bladder. Four patients suffered from posterior urethral valve. Ureterocele and urethral rhabdomyosarcoma were noted in one case each. The most common clinical manifestation was urinary tract infection. Ultrasonography, urodynamic study and voiding cystourethrogram were used to delineate the cause and help to decide the appropriate treatment. In conclusion, early detection and prevention of deteriorated renal function are important for children with urinary bladder outlet obstruction.