Urinary bladder hemangiomas in children: experience with endoscopic treatment]

Urgent arrest of bleeding is often required in hemangiomas. Endoscopic photocoagulation with Ne YAG-laser was applied in the department of urology of the Central Children's Hospital in Moscow to arrest bleeding in 5 children (2 boys and 3 girls aged 3-12 years) with hemangioma of the bladder in 1998-2009. In 3 cases the tumors were solitary (up to 5 cm), in 2 cases (multiple small 1-3 cm). The intervention was performed in the presence of hemorrhage in 3 children. One girl had intensive bleeding in photocoagulation and urgent resection of the bladder was made. Immediate hemostasis in hemorrhage was achieved in 2 of 3 patients. After a single procedure, 2 children had no bleeding for 1 and 5 years, respectively, but they retained endoscopic picture of angiomatosis. One boy after 4 sessions of photocoagulation performed with intervals 6-13 months has no manifestations of hemangioma for 4 years. A girl with multiple hemangioma undergoes photocoagulation for recurrent macrohematuria each 8-26 months. Another girl operated for bladder hemangioma has no endoscopic signs of the tumor recurrence for 2 years. Thus, photocoagulation of bladder hemangioma is an effective method of hemostasis but probability of a late recurrent bleeding after photocoagulation is higher than in open interventions. Therefore, long-term follow-up is needed and repeated endoscopic investigations with prophylactic impact on thin-walled or erosive sites of hemangioma should be made.