WOFAPS 2025 8th World Congress of Pediatric Surgery

Beytullah Yağız, Berat Dilek Demirel

Ondokuz Mayıs University, Department of Pediatric Surgery, Samsun, Turkey

Isolated bladder diverticulum is rare in children. Commonly, they are pseudo-diverticula characterized by protrusion of bladder mucosa through a detrussor muscle defect. Pneumovesicoscopy is a relatively novel minimally invasive technique of performing intravesical procedures.

A total of 13 patients are enrolled in the study with 10 boys and 3 girls. Diverticulum was on the left (n=7), right (n=4) side or was bilateral (n=2). Diverticulum was paraureteral in 10 cases and outside the trigone in 3. Three patients had co-existing vesicoureteral reflux. Ureteroneocystostomy was performed in 7 patients (3 GA 4 PL) but not deemed necessary in 6. Mean age of the patients was 8,884 ± 1,241 years. Duration of surgery was 139,818 ± 13,395 minutes in unilateral cases and 185,000 ± 10,000 minutes in bilateral cases. Median duration of follow up was 11 months (3-70) . Control cystogram was performed in 3 patients with reflux and 1 patients who had postoperative urinary tract infection and all were normal. Other patients were followed up clinicaly and by ultrasonography and all were regarded successful.

A mild to moderate type I posterior urethral valve was found in 4 boys and a urethral polip in 1 boy as an underlying condition. Two girls and 1 boy had overactive bladder.

Pneumovesicoscopic repair of bladder diverticulum appears as successful as open surgery. It provides lesser tissue trauma, better vision, exposure and cosmesis. Magnification provided by laparoscopy obviated the need for ureteroneocystostomy in 3 patients with paraureteral diverticulum.