Trauma to the bladder neck, trigone and vagina in children.

Although rare, injury to the bladder neck can occur in children following blunt lower abdominal trauma. Anterior disruption at the bladder neck (vesicoprostatic junction) may occur in boys, while rupture through the vesicovaginal septum may occur with or without vesicourethral avulsion in girls. Immediate evaluation, including excretory urography, voiding cystography, cystovaginoscopy (with a high index of suspicion of vaginal injury in girls) and retrograde urethrography (in boys), is indicated to delineate the extent of injury. Early surgical intervention is necessary to achieve realignment of the vesicourethral junction, repair a vesicovaginal injury, if present, and help assure the best chance of subsequent continence.