Clinical and urodynamics outcomes in pediatric primary bladder diverticula: a comparative study




Birgül Karaaslan, Department of Pediatric Surgery, Başakşehir Çam and Sakura Training Hospital, Istanbul, Turkey
Mehmet O. Kuzdan, Department of Pediatric Surgery, Başakşehir Çam and Sakura Training Hospital, Istanbul, Turkey


Objective: This study aimed to compare the effects of bladder diverticula smaller than 30 (SD) mm and larger than 30 mm (LD) on bladder functions and urodynamics. Materials and methods: Our retrospective analysis involved a cohort of 40 pediatric patients diagnosed with primary bladder diverticula. Results: The predicted mean bladder capacity (MBC) was 197.7 ± 95.8 mL, whereas the observed MBC was lower at an average of 170.1 ± 79.6 mL. This indicates that the observed MBC was 88.2 ± 12.9% of the predicted value (percentage). The mean diverticula diameter recorded was 33 ± 19.5 mm, and the diverticula to MBC ratio were calculated to be 0.25 ± 0.18. The distribution of urinary tract infections (UTIs) differed significantly between the groups (p < 0.001). Upper UT dilatation was significantly more common in the LD group (60%, n = 12) than in the SD group (15%, n = 3) (p = 0.003). The mean detrusor pressure (P[detrusor]) was significantly higher in the LD group (137.2 ± 24.1 cm H2O) than in the SD group (63.9 ± 5.8 cm H2O) (p = 0.001). In addition, the mean peak flow rate (Qmax) was significantly higher in the SD group (20.7 ± 7.9 mL/s) compared to the LD group (12.7 ± 3.8 mL/s) (p < 0.001). Conclusion: Bladder diverticula size is a significant factor in the clinical presentation and management of primary bladder diverticula in pediatric patients.



Keywords: Bladder. Diverticula. Vesicoureteral reflux. Urodynamic. Urinary tract infections.