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Lopes Mendes AL, Innocenzi M, Spicchiale CF, Collura G, Mele E, Del Prete L, Castagnetti M. Acute urinary retention in children: causes and the role of bladder catheterization and ultrasonogram. Minerva Urol Nephrol 2024; 76:499-504. [PMID: 38618703 DOI: 10.23736/s2724-6051.24.05696-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
BACKGROUND Acute urinary retention in children is uncommon and can be related to several causes. The role of abdominal ultrasound and catheterization is controversial. We aimed to identify the most common causes of acute urinary retention in children, focusing, particularly on the role of bladder catheterization and the diagnostic value of acute ultrasound. METHODS We retrospectively analyzed all consecutive children admitted to our emergency department with acute urinary retention from 2010 to 2020. Post-operative acute urinary retention, neonatal age, and known urological or neurological disorders were excluded. Diagnostic workup and management were adopted in each patient. Results were compared in patients with more and less than 5 years old. RESULTS 193 patients were included. Median age was 3 (2-16) years; 53.4% were girls. Ultrasound evaluation was performed in (129/193; 66.8%) patients, more commonly <5-year-old (74% vs. 26%, P<0.01). A previously unknown urological condition was detected in (16/129; 12%). The majority of patients (124/193; 64%) were managed without bladder catheterization. These patients were significantly younger than the remainder (3- vs. 4-year-old, P<0.01) and the most common diagnosis was external genitalia inflammation (53%). Of the remaining patients, (34/69; 49%) restored spontaneous micturition after a single catheterization, whereas 35 required admission. The latter were more commonly males (32%, P=0.01), with higher incidence of abnormal ultrasound (33% vs. 7%, P<0.001). CONCLUSIONS Acute urinary retention in commonly due to external genitalia inflammation, particularly in patients <5-year-old, and can be generally managed, without bladder catheterization. Abdominal ultrasound is an important diagnostic tool, that should be performed only in selected cases.
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Affiliation(s)
- Ana L Lopes Mendes
- Pediatric Urology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy -
| | - Michele Innocenzi
- Pediatric Urology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Claudia F Spicchiale
- Pediatric Urology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Tor Vergata University, Rome, Italy
| | - Giuseppe Collura
- Pediatric Urology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Ermelinda Mele
- Pediatric Urology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Laura Del Prete
- Pediatric Urology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Marco Castagnetti
- Pediatric Urology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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Foles AI, Carvalho R, Oliveira I, Carmo SP, Palácios J. Hematocolpos: An Uncommon Cause of Acute Urinary Retention and Hydronephrosis. Cureus 2024; 16:e62737. [PMID: 39036224 PMCID: PMC11259769 DOI: 10.7759/cureus.62737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2024] [Indexed: 07/23/2024] Open
Abstract
Acute urinary retention is uncommon in pediatric age and is usually associated with infection or obstruction of the urinary tract. We present the case of a 12-year-old girl admitted to the emergency room with acute urinary retention and lower urinary tract symptoms. Physical examination revealed abdominal distension and a blue-bulging mass occupying the vaginal introitus. Ultrasound confirmed the diagnosis of hematocolpos and revealed hydronephrosis, caused by compression. Kidney function and urinalysis were normal. A hymen incision and excision of redundant tissue were performed without complications. Hematocolpos is a condition caused by obstructive uterovaginal deformity. Imperforate hymen is responsible for most of the cases and usually manifests as primary amenorrhea and cyclic lower abdominal pain. The diagnosis of hematocolpos can be challenging. However, it is important to consider it in female adolescents without menarche presenting with acute urinary retention.
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Affiliation(s)
- Ana I Foles
- Pediatrics, Unidade Local de Saúde da Arrábida, Setúbal, PRT
| | - Rita Carvalho
- Pediatrics, Unidade Local de Saúde da Arrábida, Setúbal, PRT
| | - Inês Oliveira
- Pediatrics, Unidade Local de Saúde da Arrábida, Setúbal, PRT
| | - Sara P Carmo
- Pediatric Surgery, Unidade Local de Saúde da Arrábida, Setúbal, PRT
| | - Jorge Palácios
- Pediatric Surgery, Unidade Local de Saúde da Arrábida, Setúbal, PRT
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Hekmati P, Arshadi H, Kamran H, Kajbafzadeh A, Zahir M, Amirzargar H, Ghahestani SM. Three rare etiologies of urinary retention in pediatrics: A case series and review of the literature. Clin Case Rep 2023; 11:e8125. [PMID: 37927982 PMCID: PMC10622406 DOI: 10.1002/ccr3.8125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 11/07/2023] Open
Abstract
Etiology of urinary retention in pediatric age differs significantly from adults and the elderly. Therefore, a comprehensive diagnosis is crucial before specific treatment. Every effort must be made to minimize invasive procedures as far as possible in children.
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Affiliation(s)
- Pooya Hekmati
- Department of Pediatric Urology, Pediatric Urology and Regenerative Medicine Research Center, Pediatrics Center of ExcellenceTehran University of Medical SciencesTehranIran
| | - Hamid Arshadi
- Department of Pediatric Urology, Pediatric Urology and Regenerative Medicine Research Center, Pediatrics Center of ExcellenceTehran University of Medical SciencesTehranIran
| | - Hooman Kamran
- Department of Pediatric Urology, Pediatric Urology and Regenerative Medicine Research Center, Pediatrics Center of ExcellenceTehran University of Medical SciencesTehranIran
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Abdol‐Mohammad Kajbafzadeh
- Department of Pediatric Urology, Pediatric Urology and Regenerative Medicine Research Center, Pediatrics Center of ExcellenceTehran University of Medical SciencesTehranIran
| | - Mazyar Zahir
- Department of Pediatric Urology, Pediatric Urology and Regenerative Medicine Research Center, Pediatrics Center of ExcellenceTehran University of Medical SciencesTehranIran
- Urology and Nephrology Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Hossein Amirzargar
- Department of Pediatric Urology, Pediatric Urology and Regenerative Medicine Research Center, Pediatrics Center of ExcellenceTehran University of Medical SciencesTehranIran
| | - Seyyed Mohammad Ghahestani
- Department of Pediatric Urology, Pediatric Urology and Regenerative Medicine Research Center, Pediatrics Center of ExcellenceTehran University of Medical SciencesTehranIran
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Castle JT, Levy BE, Allison DB, Rodeberg DA, Rellinger EJ. Pediatric Rhabdomyosarcomas of the Genitourinary Tract. Cancers (Basel) 2023; 15:2864. [PMID: 37345202 PMCID: PMC10216134 DOI: 10.3390/cancers15102864] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/19/2023] [Accepted: 05/20/2023] [Indexed: 06/23/2023] Open
Abstract
Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in the pediatric and adolescent population, with 350 new cases diagnosed each year. While they can develop anywhere in the body, the genitourinary tract is the second most common primary location for an RMS to develop. Overall survival has improved through the increased use of protocols and multidisciplinary approaches. However, the guidelines for management continue to change as systemic and radiation therapeutics advance. Given the relative rarity of this disease compared to other non-solid childhood malignancies, healthcare providers not directly managing RMS may not be familiar with their presentation and updated management. This review aims to provide foundational knowledge of the management of RMSs with an emphasis on specific management paradigms for those arising from the genitourinary tract. The genitourinary tract is the second most common location for an RMS to develop but varies greatly in symptomology and survival depending on the organ of origin. As the clinical understanding of these tumors advances, treatment paradigms have evolved. Herein, we describe the breadth of presentations for genitourinary RMSs with diagnostic and treatment management considerations, incorporating the most recently available guidelines and societal consensus recommendations.
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Affiliation(s)
- Jennifer T. Castle
- Department of Surgery, Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA;
| | - Brittany E. Levy
- Department of Surgery, University of Kentucky, Lexington, KY 40536, USA;
| | - Derek B. Allison
- Department of Pathology and Laboratory Medicine, Department of Urology, Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA;
| | - David A. Rodeberg
- Department of Surgery, Department of Pediatric Surgery, University of Kentucky, Lexington, KY 40536, USA;
| | - Eric J. Rellinger
- Department of Surgery, Department of Pediatric Surgery, Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA
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Karava V, Chainoglou A, Stefanidis C, Tsikopoulos G, Zafeiriou D, Stabouli S. Sacrococcygeal Teratoma in an Infant with Acute Urinary Retention. J Pediatr 2022; 247:170-171.e1. [PMID: 35427691 DOI: 10.1016/j.jpeds.2022.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 04/07/2022] [Indexed: 10/18/2022]
Affiliation(s)
- Vasiliki Karava
- Pediatric Nephrology Unit, 1st Department of Pediatrics, Hippokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athanasia Chainoglou
- Pediatric Nephrology Unit, 1st Department of Pediatrics, Hippokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos Stefanidis
- Pediatric Surgery Department, Hippokratio General Hospital, Thessaloniki, Greece
| | - Georgios Tsikopoulos
- Pediatric Surgery Department, Hippokratio General Hospital, Thessaloniki, Greece
| | - Dimitrios Zafeiriou
- Pediatric Nephrology Unit, 1st Department of Pediatrics, Hippokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stella Stabouli
- Pediatric Nephrology Unit, 1st Department of Pediatrics, Hippokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Selvi I, Dönmez Mİ, Ziylan O, Oktar T. Urodynamically proven lower urinary tract dysfunction in children after COVID-19: A case series. Low Urin Tract Symptoms 2022; 14:301-304. [PMID: 35293147 PMCID: PMC9115155 DOI: 10.1111/luts.12436] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/17/2022] [Accepted: 02/27/2022] [Indexed: 01/03/2023]
Abstract
CASE Since the declaration of COVID-19 as a pandemic, other unexpected symptoms related to the infection besides the respiratory system have been reported. Although a few case reports have revealed that adult patients with COVID-19 also complained of urinary frequency and nocturia, the exact pathophysiology is still unclear. In this case series, we present three children aged 14 to 17 years with urodynamically proven lower urinary tract dysfunction (LUTD) following COVID-19. OUTCOME None of the patients had constipation or bowel disorder before the diagnosis of COVID-19. In addition, neurological examination and related imaging revealed no signs of etiological factors. The median time from diagnosis of COVID-19 infection to the onset of lower urinary tract symptoms was 3 months. Incomplete bladder emptying/urinary retention supported by increased bladder compliance, high post-micturition residual urine volumes, and absence of detrusor pressure increase during the voiding phase in the pressure flow study (acontractile detrusor in two patients and hypocontractile detrusor in one patient) were observed. CONCLUSION We observed that LUTD (eg, incomplete bladder emptying, urinary retention) can be prominent some time after the diagnosis of COVID-19. Even though psychogenic or neurogenic causes may not be excluded completely, clinicians should be aware of a recent COVID-19 infection in children with sudden-onset LUTD.
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Affiliation(s)
- Ismail Selvi
- Division of Pediatric Urology, Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Muhammet İrfan Dönmez
- Division of Pediatric Urology, Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Orhan Ziylan
- Division of Pediatric Urology, Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tayfun Oktar
- Division of Pediatric Urology, Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.,Department of Urology, Koç University School of Medicine, Istanbul, Turkey
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