ABSTRACT
The narrow bony pelvis of the child leads to the bladder occupying a more intra-abdominal position than in the adult. This creates relatively easy access to the bladder and perivesical space. Percutaneous bladder access is quite familiar to pediatric urologists, with suprapubic aspiration for culture being a standard practice for many years. In addition, placing a needle or port directly into the distended bladder may allow access for other procedures, including:
■ placement of a suprapubic catheter ■ antegrade ablation of a posterior urethral valve ■ injection of bulking agents at the bladder neck ■ catheterization of ureteral orifices with an unusual
orientation (such as after Cohen’s reimplant).
