Bladder shrinkage as a complication of long-term supravesical urinary diversion in children with solitary kidneys.

Abstract

Failures in the treatment of terminal ureteral stenosis are not seldom burdened by considerable bladder shrinkage, particularly in infants. Congenital anomalies of the urinary tract such as bilaterally ectopic ureteral ostia can also lead to bladder shrinkage, even in newborns. Using examples from our patient series, we discuss problems of contracted bladder in children and describe a method of continuous bladder distention by means of catheters with different balloon volumes and a simultaneous, intermittent, hydrostatic bladder dilatation. This method enables reintegration of a bladder which has been excluded from the urinary drainage system for a long period of time into the urinary tract, even in complicated cases, thus avoiding a permanent supravesical urinary diversion.