A study of the vesical ganglia in children and the relationship to the megaureter megacystis syndrome and Hirschsprung's disease

Abstract

A method for the assay of vesical ganglion cells is described and the number and distribution of the neurones in three normal bladders was studied. Vesical ganglion counts were done in cases of the megaureter-megacystis syndrome, megaureter, bladder neck obstruction, megacystis associated with absent abdominal muscles, Hirschsprung's disease, and lumbar myelomeningocoele. A normal complement of neurones was found in each case. No evidence was found that the megaureter-megacystis syndrome is due to an agenesis of the peripheral autonomic ganglia similar to that in Hirschsprung's disease. Vesical ganglia were normal in the two cases examined and no clinical association was found between the two conditions in a large series of cases. Moreover, a study of the cell counts suggests that at least some of the reports of such a lesion are based upon an inadequate appreciation of the number and distribution of neurones in the normal urinary tract.