RETROPUBIC APPROACH TO BLADDER NECK RESECTION IN CHILDREN

CONTRACTURE of the vesical neck is one of the commonest congenital anomalies of the genitourinary tract. The highest incidence occurs in children below 6 years of age, but, since many cases are either not detected or the childhood symptoms not recognized until the second or third decade, the true incidence is uncertain.

These symptoms are often identical with those of prostatism and other forms of lower urinary tract obstruction found in the adult. Frequently they are undetected or ignored by the physician until back pressure has caused dilatation of the upper urinary tract to an advanced and sometimes irreversible degree. Eneuresis resistent to psychiatric management or repeated episodes of urinary tract infection refractory to symptomatic treatment may on proper investigation prove to be due to an obstructive uropathy responsive only to surgical correction. Occasionally, a patient is referred to the urologist for such late manifestations of the disease as an