Pneumovesicoscopic treatment of congenital bladder diverticula in children: our experience.
OBJECTIVE
In this article, we report our experience with diverticulectomies of symptomatic congenital bladder diverticula in children, which was performed by utilizing pneumovesicoscopy.


METHODS
Six boys, 4-8 years of age (mean, 5.6) underwent pneumovesicoscopic diverticulectomy at our institution from June 2007 to June 2008. There were 4 right-single diverticula and 2 double-left diverticula. Under cystoscopic control, after the cystopexy to the abdominal wall, a midline 5-mm trocar for a 0-degree telescope and two lateral 3-mm reusable trocars through the anterolateral wall of the bladder in the midclavicular line were introduced, insufflating the bladder with carbondioxide to 10-12 mm Hg pressure. The diverticulum/a were inverted into the bladder and the mucosa around the neck was circumcized by using scissors and a monopolar hook. The defect was sutured with interrupted sutures and the bladder was drained with a Foley catheter, which was introduced at the site of the 5-mm port, and a urethral catheter.


RESULTS
Mean operative time was 110 minutes. No major peri- or postoperative complications were recorded, except that the displacement of one of the lateral trocars that resulted in gas leakage in 1 case. The trocar was replaced and the procedure was completed. An ultrasound and a voiding cystourethrogram, performed from 3 to 6 months after the operation, showed the disappearance of the diverticulum/a.


CONCLUSIONS
In our experience, pneumovesicoscopic diverticulectomy is an easy, safe procedure and can be considered a valid alternative to the open or laparoscopic procedures. It also provides no postoperative discomfort and a good cosmetic result.
Marte
Antonio
A
Department of Pediatric Surgery, Second University of Naples, Naples, Italy. antonio.marte@unina2.it
Sabatino
Maria D
MD
Borrelli
Micaela
M
Del Balzo
Biago
B
Nino
Fabiano
F
Prezioso
Maurizio
M
Parmeggiani
Pio
P
D002648:Child; D002675:Child, Preschool; D003558:Cystoscopy / Q000379:methods*; D004240:Diverticulum / Q000151:congenital* / Q000601:surgery*; D006801:Humans; D007327:Insufflation; D008297:Male; D001745:Urinary Bladder Diseases / Q000151:congenital* / Q000601:surgery*