title: Primary congenital bladder diverticula: Where does the ureter drain?
abstract: BACKGROUND
  Primary congenital bladder diverticulum (PCBD) is related to a deficient detrusor layer allowing out-pouching of the bladder mucosa through the inadequate muscularis wall. We aimed to review our experience with symptomatic PCBD in order to correlate clinical findings with anatomical aspects and to present late outcome.
  
  
  METHODS
  We reviewed all patients operated in our institution since 2004. We evaluated the charts for complaints, radiological exams, method of treatment, complications and length of follow-up.
  
  
  RESULTS
  We treated 10 cases (11 renal units - [RU]), predominantly males (9/10), mean age at surgery of 5.3 years. All patients had significant urological complaints presenting either with antenatal hydronephrosis (4) or febrile urinary tract infection (5) and urinary retention in one. The ureter was found implanted inside the diverticulum in 8/11 RU. An extravesical psoas-hitch ureteroneocystostomy and diverticulum resection was performed in 10/11 cases, whereas 1 case was treated intravesically based on surgeon's preference without performing cystoscopy. Mean follow-up was 34.1 months (1-120) without complications.
  
  
  CONCLUSIONS
  PCBD is an uncommon diagnosis and has a high probability of drainage inside the diverticulum (72.7%). We recommend the extravesical approach associated with diverticulectomy and ureteroneocystostomy as the preferred technique to treat this abnormality.
authors.forename: Antonio
authors.initials: A
authors.lastname: Macedo
authors.forename: Gilmar
authors.initials: G
authors.lastname: Garrone
authors.forename: Sérgio Leite
authors.initials: SL
authors.lastname: Ottoni
authors.forename: Diego Estevam
authors.initials: DE
authors.lastname: Oliveira
authors.forename: Geórgia Rubiane Meira do Rosário
authors.initials: GR
authors.lastname: Souza
authors.affiliation: Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Marcela Leal da
authors.initials: ML
authors.lastname: Cruz
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003558:Cystoscopy / Q000379:methods*; D004240:Diverticulum / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics / Q000502:physiology*; D014567:Urography