Isolated congenital megacystis without intestinal obstruction: a mild variant of chronic intestinal pseudoobstruction syndrome?

Spontaneous resolution of isolated congenital megacystis: The incredible shrinking bladder

“…Previous reports have postulated various underlying mechanisms including spontaneous resolution of a congenital urethral stricture,[12] visceral myopathy[1] and a variant of MMHIS. [2] In some cases no clear etiology can be identified, as was the situation with our patient.…”

“…[10] In addition, ICM tends to have a favorable prognosis compared with megacystis contained within the context of a larger syndrome. [2–4] Parents can thus be presented with the range of possibilities based on the prenatal ultrasound, but exact prognostication is nearly impossible. Increased renal echogenicity has been highly associated with obstructive etiologies of bladder distension,[11] so an initial attempt at stratification can be made based on that ultrasonographic parameter.…”

“…Previous reports have discussed the use of reduction cystoplasty[3] and CIC[2, 4] for the management of this condition; both strategies resulted in favorable clinical outcomes. Our report highlights a case where conservative management of megacystis with serial imaging and prophylactic antibiotics was a successful alternative strategy.…”

“…Postulated pathologic mechanisms include a visceral myopathy[1] and a mild variant of megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS). [2] Due to the rarity of this condition, the optimal strategy for management is unclear, with previous authors reporting reduction cystoplasty[3] and clean intermittent catheterization (CIC)[2, 4] as two options. Here, we report a case of ICM that resolved spontaneously over the first year of life.…”