• Relationship between urothelial metaplasia and neuromuscular bladder dysfunction in children
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Relationship between urothelial metaplasia and neuromuscular bladder dysfunction in children

Paediatric Surgery.2017.3(56):84-88; doi 10.15574/PS.2017.56.84

Jurkiewicz B., Shevchuk D. V., Załęska K.
Department of Pediatric Surgery and Pediatric Urology, CPME, Warsaw – Hospital in Dziekanowie Leśnym, Poland
Municipal Establishment «Zhytomyr Regional Children’s Clinical Hospital», Ukraine, Ukraine
Zhytomyr Ivan Franko State University,, Zhytomyr, Ukraine
Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine

Objective. To establish a connection between non-keratinized squamous urothelial metaplasia and neuromuscular bladder dysfunction in children.
Material and methods. Endoscopic methods of diagnosis and treatment of urinary tract diseases in children are used in the surgical departments of Zhytomyr Regional Children’s Clinical Hospital. In general, 392 endoscopic urinary tract studies were performed from 2007 to 2016.
Results. The number of patients who were offered an endoscopic urinary tract examination for bladder dysfunction was 296 (75.5%). From 2014, diagnostic cystoscopy revealed local changes in the mucous membrane of urinary bladder in the form of non-keratinizing metaplasia of urothelia in 5 patients aged from 13 to 17 years old, all were female.The clinical case of diagnosed non-keratinizing urothelial metaplasia in 13-year old girl with neuromuscular bladder dysfunction is presented.
Conclusions. Squamous urothelial metaplasia is a rather rare disease in childhood. All patients with neuromuscular dysfunction of bladder should receive a complete urological examination with mandatory cystoscopy to determine the presence of urothelial metaplasia, in the case of confirmation, a mandatory biopsy of mucosa in order to exclude neoplasia is provided.
Key words: neuromuscular bladder dysfunction, urothelial metaplasia, children.


1. Schlager TA, Grady R, Mills SE, Hendley JO. (2004). Bladder epithelium is abnormal in patients with neurogenic bladder due to myelomeningocele. Spinal Cord. 42: 163–168. https://doi.org/10.1038/sj.sc.3101565.

2. Jurkiewicz B, Matuszewski Ł, Bokwa T et al. (2006). Bladder Squamous Metaplasia of the Urothelium – Introductory Report. Urol Int. 77: 46–49. – URL: https://doi.org/10.1159/000092934 PMID:16825815.

3. Tramoyeres-Galvan А, Ivorra JAC, Sanchez-Ballester F et al. (2005). Case report of bladder squamous metaplasia. Literature review. Archivos Espanoles de Urologia. 58; 1: 74–76.

4. Jain P, Mishra A, Misra DS. (2014). Keratinizing squamous metaplasia of the upper urinary tract in a child with a solitary kidney. Indian J Urol. 30: 230–232. https://doi.org/10.4103/0970-1591.126916.

5. Jurkiewicz B, Zаbkowski T. (2014). Nonkeratinised Squamous Metaplasia of the Urinary Bladder in Children: A Report of Case Experiences. BioMed Research International. Article ID 936970: 6. URL: https://doi.org/10.1155/2014/936970.

6. Jurkiewicz B, Bokwa T, Matuszewski Ł et al. (2005). Metaplazja płaskonabłonkowa nabłonka urotelialnego błony sluzowej pęcherza moczowego-doniesienie wstępne. Pediatria i Medycyna Rodzinna. 1; 4: 266–271.

7. Ankem MK, Grotas AB, Shurtleff B et al. (2002). Nonkeratinizing squamous metaplasia of the bladder in children. Infections in Urology. 15: 22–25.

8. Lian DWQ, Li FX, Ong CCP et al. (2014). Pseudomembranous trigonitis in a male with Klinefelter syndrome: a case report and evidence of a hormonal etiology. Int J Clin Exp Pathol. 7(6): 3375–3379. ISSN:1936-2625. IJCEP0000435.

9. Girshovich A, Vinsonneau C, Perez J et al. (2012). Ureteral obstruction promotes proliferation and differentiation of the renal urothelium into a bladder-like phenotype. Kidney Int. 82: 428–435. https://doi.org/10.1038/ki.2012.110; PMid:22513823

10. Young RH, Eble JN. (2008). Non-neoplastic disorders of the urinary bladder. Urologic surgical pathology: 221–222.

11. Youngson GG, Galley R, Johnston PW. (1990). Columnar Metaplasia Complicating Neurogenic Bladder In A Child. British Journal Of Urology. 65: 211–212. https://doi.org/10.1111/j.1464-410X.1990.tb14704.x; PMid:2317660