The Asphyxiated Bladder as a Cause of Delayed Micturition in the Newborn

Abstract

Although delayed micturition in the immediate newborn period is ofter a normal physiologic variation it may be associated with pathological states leading to a decrease in urine formation or reduction of urine flow. Recently, 5 newborns subjected to severe perinatal stress were seen, who exhibited delayed micturition despite adequate urine formation and no evidence of gross anatomic abnormalities. These patients presented with distended bladders that could be maneuvered easily by Credé's method. We believe that these cases represent a heretofore undescribed asphyxiated bladder syndrome and suggest consideration of such a diagnosis when bladder distension occurs subsequent to an asphyxial event. In male newborns it is important to differentiate this syndrome from posterior urethral valves and if urine is not expressed easily one should consider early intervention with diagnostic studies and, perhaps, suprapubic drainage.