BLADDER DYSFUNCTION - AN INTEGRAL-PART OF THE ECTOPIC URETEROCELE COMPLEX

Purpose: We evaluate whether bladder dysfunction is common in patients with ectopic ureterocele and, if so, whether it is an integral part o f the ectopic ureterocele complex or a result of surgery. Materials an d Methods: From 1986 to 1995, 34 patients with a mean age of 10 months were treated for large or medium ectopic ureteroceles at our institut ion and 32 participated in postoperative followup. Bladder function wa s investigated by a careful history and repeat uroflowmetry, and resid ual urine estimation was assessed by ultrasound and cystometry. Result s: Of the 32 patients 19 had infrequent voiding and 3 had incontinence . Cystometric bladder capacity was increased to greater than 150% of t he normal value for age in 15 of 27 patients (55%). Uroflowmetry revea led greater than 5 mi. residual urine in 15 patients (56%). Postoperat ively no radiological signs of bladder neck obstruction were found. In creased bladder capacity and residual urine did not correlate with ure terocele size or location, or surgical procedure. There was no progres sion of bladder dysfunction with age. Conclusions: Children with ectop ic ureterocele are at high risk for a high capacity bladder with incom plete emptying. This bladder dysfunction associated with ectopic urete rocele does not seem to be the result of surgery but an integral part of the disorder.