Congenital Megacystis
Congenital megacystis is a rare distension of the bladder with thin walls and massive vesicoureteral reflux. The distension of the bladder starts prenatally. Voiding leads to reflux into the ureters, leading to ureteral distension and gradual increase in bladder capacity. Since not every patient with vesicoureteral reflux develops megacystis, the following co-factors play a role in bladder distension: bacterial infections, connective tissue diseases or perinatal cerebral hypoxia. If the congenital megacystis occurs in association with the microcolon-intestinal hypoperistalsis syndrome, the prognosis quod ad vitam is bad due to intestinal obstruction (Puri and Shinkai, 2005).
After birth, an antibiotic prophylaxis should be started. The surgical treatment (after 6 months) is directed against the vesicoureteral reflux. A reduction cystoplasty is usually not necessary (Mandell et al, 1992).
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References
- Mandell, J.; Lebowitz, R. L.; Peters, C. A.; Estroff, J. A.; Retik, A. B. & Benacerraf, B. R.
- Prenatal diagnosis of the megacystis-megaureter association.
J Urol, 1992, 148, 1487-1489 - Puri, P. & Shinkai, M.
- Megacystis microcolon intestinal hypoperistalsis syndrome.
Semin Pediatr Surg, 2005, 14, 58-63
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Dr. med. Dirk Manski
man...@urologielehrbuch.de