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Ramirez-Amoros C, Estefania-Fernandez K, Moratilla-Lapeña L, Vilanova-Sanchez A, Lopez Pereira P, Martinez Urrutia MJ. Bladder duplication in a patient with a persistent urogenital sinus: Case report and systematic review of the literature. Urol Case Rep 2024; 54:102736. [PMID: 38645772 PMCID: PMC11033084 DOI: 10.1016/j.eucr.2024.102736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/04/2024] [Accepted: 04/09/2024] [Indexed: 04/23/2024] Open
Abstract
Bladder duplication (BD) is a rare malformation that is often associated to other anomalies. We report a newborn diagnosed with BD in the sagittal plane, associated to persistent urogenital sinus (UGS), given the opening of the vagina immediately below the bladder neck. It is the fourth time this association is reported. Surgical repair was made: both bladders were joined, the common channel was left as urethra and the vagina was descended with a vaginoplasty with an intestinal segment. She also presented an anterior anus, that required posterior mobilization. The patient is currently 3 years old with good sphincter control.
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Affiliation(s)
- Carla Ramirez-Amoros
- La Paz Children's University Hospital, Department of Paediatric Surgery, Madrid, Spain
| | | | | | | | - Pedro Lopez Pereira
- La Paz Children's University Hospital, Department of Paediatric Surgery, Madrid, Spain
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Claeys W, Jamaer C, Abramowitz D, Berquin C, Verbakel I, Ploumidis A, Hoebeke P, Van Laecke E, Spinoit AF. Exstrophic bladder duplication in the sagittal plane: Surgical management of a rare case. J Pediatr Urol 2023:S1477-5131(23)00134-1. [PMID: 37150636 DOI: 10.1016/j.jpurol.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 04/03/2023] [Accepted: 04/07/2023] [Indexed: 05/09/2023]
Abstract
INTRODUCTION The bladder-Exstrophy-Epispadias complex (BEEC) contains a wide spectrum of congenital malformations. A treatment naïve refugee was referred to our center with what was identified as BEEC. MATERIALS AND METHODS A 27-year-old female patient was referred for total incontinence since birth by the general practitioner from the refugee center. An exstrophic bladder with blind ending ureteral orifices and a second non-exstrophic bladder with two orthotopic ureters was identified, demonstrating the bladder duplication in the sagittal plane. Laparotomy was performed, dissecting the exstrophic bladder plate caudally and using it as a ventral onlay to augment the non-exstrophic bladder. A Mitchell-type bladder neck reconstruction was performed with an autologous fascia sling around the bladder neck to obtain continence. As the patient had never voluntarily voided, chances of spontaneous voiding after surgery were low. Therefore creation of a continent Mitrofanoff-type vesicostomy was additionally realized and genital reconstruction was achieved. RESULTS 12 months post operatively, the patient was completely continent, had a bladder capacity of 250 ml, and performed self-catheterization 5 times a day. No post-operative complications were observed. CONCLUSION Admission of political refugees can implicate challenging surgeries for congenital malformations in adults, such as BEEC. This demonstrates the importance of multidisciplinary transitional care.
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Affiliation(s)
- Wietse Claeys
- Department of Urology, Ghent University Hospital, ERN eUROGEN accredited centre, Ghent, Belgium
| | - Caroline Jamaer
- Department of Urology, Ghent University Hospital, ERN eUROGEN accredited centre, Ghent, Belgium; Department of Urology, JessaZiekenhuis, Hasselt, Belgium
| | - D Abramowitz
- Department of Urology, Ghent University Hospital, ERN eUROGEN accredited centre, Ghent, Belgium; University at Buffalo, Buffalo, NY, USA
| | - C Berquin
- Department of Urology, Ghent University Hospital, ERN eUROGEN accredited centre, Ghent, Belgium
| | - I Verbakel
- Department of Urology, Ghent University Hospital, ERN eUROGEN accredited centre, Ghent, Belgium
| | - A Ploumidis
- Department of Urology, Ghent University Hospital, ERN eUROGEN accredited centre, Ghent, Belgium; Athens Medical Centre, Athens, Greece
| | - P Hoebeke
- Department of Urology, Ghent University Hospital, ERN eUROGEN accredited centre, Ghent, Belgium
| | - E Van Laecke
- Department of Urology, Ghent University Hospital, ERN eUROGEN accredited centre, Ghent, Belgium
| | - A F Spinoit
- Department of Urology, Ghent University Hospital, ERN eUROGEN accredited centre, Ghent, Belgium.
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Tamasi S, Nessuno F, D'Arcangelo R, Di Iorio G, Zeccolini M. Bladder duplication in infant girls: role of imaging in two rare cases with variants of a complete sagittal septum. Pediatr Radiol 2023. [PMID: 36688972 DOI: 10.1007/s00247-023-05603-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/14/2022] [Accepted: 01/10/2023] [Indexed: 01/24/2023]
Abstract
Bladder duplication is an extremely rare congenital anomaly of the urinary system that is more frequent in boys; the literature is limited to case reports and case series. We describe two cases of bladder duplication in two infant girls with an uncommon variant of complete sagittal septum not included in the Abrahamson classification. The diagnosis was made using magnetic resonance urography, combining excellent anatomical information and static and dynamic evaluation of the urinary tract. The diagnostic information provided by MR-urography was confirmed on surgical exploration. These cases provide an opportunity for paediatric radiologists and urologists to learn more about bladder duplication and improve their diagnosis of this rare condition.
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Freitas Filho LG, Carvalho Fonseca AC, Guerreiro Paiva TR, Stephane de Medeiros Jerônimo B, Magalhães RM, Gomes Abreu MC, Budib LJ. Bladder and urethral duplication and a bladder exstrophy plate with omphalocele in a female child. Urol Case Rep 2021; 39:101769. [PMID: 34285880 DOI: 10.1016/j.eucr.2021.101769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 06/30/2021] [Accepted: 07/05/2021] [Indexed: 11/20/2022] Open
Abstract
The Exstrophy – Epispadias Complex (EEC) is a spectrum of rare congenital malformations involving the urinary, genital and musculoskeletal systems. We present an atypical or variant case of EEC in which a bladder plate is found involving a small omphalocele, separated pubic bones and bladder and urethral duplication. The treatment had a favorable outcome, with bladder control and the child voiding normally. Perhaps the best accepted embryonic theory to explain exstrophy and its variants should be reviewed as it fails to satisfactorily explain the alterations we found.
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Martin B, Ali S, McGuirk SP, Chandran H. Bilateral hydroureteronephrosis: A neonatal presentation of bladder duplication. Radiol Case Rep 2021; 16:1237-41. [PMID: 33868527 DOI: 10.1016/j.radcr.2021.02.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 02/27/2021] [Accepted: 02/28/2021] [Indexed: 11/23/2022] Open
Abstract
In a male neonate with bilateral hydroureteronephrosis, the most common surgical diagnosis is posterior urethral valves. This case report describes a male infant with the same presentation, but caused by a very uncommon congenital anomaly. The summation of different imaging modalities allowed a multidisciplinary team of colleagues to define the anatomy: bilateral duplex kidneys draining into separate urinary bladders. Only one of the bladders had an outlet, hence the obstructive uropathy to the right kidney led to total loss of function. The distended tortuous ureters produced a mass effect at presentation. This case acts as a reminder that complex congenital anomalies can mimic the presentation of more common conditions, and that they often require input from various specialists to diagnose the condition and guide its management.
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Abstract
OBJECTIVE Complete bladder duplication is a male predominant rare congenital malformation usually diagnosed at birth. Owing to the rarity of this anomaly, only few reports have discussed the surgical approach for this condition, with the open approach for excision being the most common. We hereby present a video of a laparoscopic resection of complete bladder and urethral duplication in a 1-year-old male. METHODS The patient presented to our clinic with a red mucosal tissue protruding from a cutaneous opening at the dorsal base of the penis that has been present from birth. A normally located and functioning bladder and urethra were present. During work-up, a cystic mass located above the bladder was discovered in imaging examinations. No other anomalies were found. After a shared decision process, we performed a laparoscopic transperitoneal bladder duplication excision during which the accessory urethra and duplicated bladder were removed with preservation of the adjacent normal urethra. The patient had an uneventful recovery with excellent cosmetic results. CONCLUSION The minimally invasive approach can be utilized for treatment of complex urinary anomalies in young children.
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Affiliation(s)
- Eyal Kord
- Department of Urology, Assaf Harofeh Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Amnon Zisman
- Department of Urology, Assaf Harofeh Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Guy Verhovsky
- Department of Urology, Assaf Harofeh Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amos Neheman
- Department of Urology, Assaf Harofeh Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Lam JY, Lopushinsky SR, Kurek KC, Beaudry P. Unusual case of coronal complete bladder duplication associated with rectoprostatic fistula to duplicated prostatic urethra. Pediatr Surg Int 2018; 34:105-108. [PMID: 29027581 DOI: 10.1007/s00383-017-4200-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/05/2017] [Indexed: 11/25/2022]
Abstract
Anorectal malformations are a common congenital anomaly, while bladder duplication is rare. Bladder duplications are classified as complete or incomplete and sagittal or coronal. We present a rare case of coronal complete bladder duplication with rectoprostatic fistula to the blind ending prostatic urethra of the duplicated bladder.
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Affiliation(s)
- Jennifer Y Lam
- Department of Pediatric Surgery, University of Calgary, Alberta Children's Hospital, 3rd Floor Surgery Administration Offices, 2888 Shaganappi Trail NW, Calgary, AB, T3B 6A8, Canada.
| | - Steven R Lopushinsky
- Department of Pediatric Surgery, University of Calgary, Alberta Children's Hospital, 3rd Floor Surgery Administration Offices, 2888 Shaganappi Trail NW, Calgary, AB, T3B 6A8, Canada
| | - Kyle C Kurek
- Department of Pathology and Laboratory Medicine, University of Calgary, Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, AB, T3B 6A8, Canada
| | - Paul Beaudry
- Department of Pediatric Surgery, University of Calgary, Alberta Children's Hospital, 3rd Floor Surgery Administration Offices, 2888 Shaganappi Trail NW, Calgary, AB, T3B 6A8, Canada
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Awasthi NK, Goel H, Mahapatra R, Pal D. Incomplete bladder duplication with multiple congenital anomalies: A rare presentation. Urol Ann 2015; 7:88-90. [PMID: 25657553 PMCID: PMC4310127 DOI: 10.4103/0974-7796.148628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 07/31/2013] [Indexed: 11/04/2022] Open
Abstract
We report a rare case of incomplete bladder duplication associated with multiple congenital malformation. The patient presented with a symptomatic left pelvi-ureteric junction obstruction which was surgically managed. To the best of our knowledge, this type of bladder duplication with such syndromic association is not yet reported in literature.
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Affiliation(s)
| | - Hemantkumar Goel
- Department of Urology, I. P. G. M. E. & R., Kolkata, West Bengal, India
| | | | - Dilipkumar Pal
- Department of Urology, I. P. G. M. E. & R., Kolkata, West Bengal, India
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