Overview
Primary vesical varices are exceptionally rare vascular anomalies characterized by dilated veins within the bladder wall, often presenting with hematuria 1.Diagnosis
Clinical Presentation: Recurrent gross hematuria 1.
Imaging Studies: Ultrasonography, enhanced CT, and voiding cystourethrogram may reveal submucosal masses or abnormalities 1.
Direct Visualization: Cystoscopy essential for identifying dilated submucosal veins 1.
Histopathologic Confirmation: Biopsy or resection specimen examination confirms the diagnosis of varices 1.Management
Surgical Intervention: Ablation of the varices via cystoscopic techniques 1.
Follow-Up: Regular monitoring post-ablation to assess for recurrence of hematuria 1.Special Populations
Pediatrics: Primary vesical varices have been reported in children, requiring careful diagnostic and therapeutic approaches 1.Key Recommendations
Perform cystoscopy for definitive diagnosis of vesical varices when hematuria is recurrent and imaging suggests submucosal abnormalities (Evidence: Weak 1).
Consider surgical ablation for symptomatic vesical varices to manage hematuria effectively (Evidence: Weak 1).
Implement postoperative surveillance in pediatric patients to monitor for recurrence and ensure long-term outcomes (Evidence: Expert opinion 1).References
1 Hou Y, Xue Y, Yang Y, Sun RG. Vesical varices causing gross hematuria in a four-year-old girl. Urology 2012. link