PATHOLOGY OF THE URETEROVESICAL JUNCTION IN NEUROGENIC BLADDERS IN CHILDREN AND ADOLESCENTS - A RETROSPECTIVE STUDY OF 119 PATIENTS

Ureterovesical junction dysfunction in congenital or acquired neurogen ic bladders represents a threat for the renal parenchyma. In order to evaluate the incidence, mechanisms of development and preventive and c urative treatments proposed in diseases of the ureterovesical junction associated with neurogenic bladders, the files of 119 children were r etrospectively evaluated. 68 patients suffered from congenital neuroge nic bladder and 51 had an acquired neurogenic bladder. In the congenit al neurogenic bladder group, vesico-ureteric reflux was observed in 22 cases (32%) and dilatation was observed in 18 cases (26.5%), while 21 patients had both dilatation and reflux. In the acquired neurogenic b ladder group, reflux was observed in 8 cases (16%) and dilatation was observed in 3 cases (10%), one of whom had both reflux and dilatation, The predominant mechanism of decompensation of the ureterovesical jun ction in the two groups was a combination of low compliance and high p eripheral resistance. In patients with abnormalities of the ureteroves ical junction, the incidence of associated parenchymal lesions was sim ilar (30%) whether neurogenic bladder was congenital or acquired. The disparities between theses two comparable patient groups, the preventi ve and curative treatments proposed and their results are analysed in comparison with the data reported in the literature.