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Related Experiment Videos

Bladder-sphincter dysfunction in myelomeningocele.

J D van Gool1, P Dik, T P de Jong

  • 1Paediatric Renal Centre WKZ, Wilhelmina Kinderziekenhuis, University Medical Centre Utrecht, PO Box 85090, 3508 AB Utrecht, The Netherlands. jd.vangool@attglobal.net

European Journal of Pediatrics
|July 31, 2001
PubMed
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Pediatric urodynamics reveals that detrusor-sphincter dyssynergia causes bladder outlet obstruction in half of children with myelomeningocele, leading to renal damage. Early identification and management of pelvic floor and detrusor overactivity are crucial for preserving kidney and bladder function.

Area of Science:

  • Pediatric Urology
  • Neurogenic Bladder Management

Background:

  • Myelomeningocele is associated with neurogenic bladder dysfunction, potentially leading to renal damage.
  • Detrusor-sphincter dyssynergia (DSD) is a common cause of bladder outlet obstruction in children with myelomeningocele.
  • Independent abnormalities in pelvic floor and detrusor muscle activity can occur.

Purpose of the Study:

  • To highlight the insights gained from pediatric urodynamics in understanding bladder dysfunction in myelomeningocele.
  • To emphasize the impact of these insights on the management of affected children.
  • To underscore the importance of early diagnosis and intervention.

Main Methods:

  • Utilizing pediatric urodynamics to assess bladder and sphincter function in children with myelomeningocele.

Related Experiment Videos

  • Identifying patterns of detrusor-sphincter dyssynergia and detrusor overactivity.
  • Correlating urodynamic findings with potential for renal damage.

    • Main Results:

    • Detrusor-sphincter dyssynergia is identified in approximately 50% of children with myelomeningocele, causing functional bladder outlet obstruction.
    • This obstruction can lead to obstructive uropathy and subsequent renal damage, similar to anatomical obstructions.
    • Abnormal pelvic floor and detrusor activity can occur independently, requiring tailored management strategies.

    Conclusions:

    • Pediatric urodynamics provides critical information for managing neurogenic bladder in myelomeningocele.
    • Early identification of pelvic floor overactivity allows for timely clean intermittent catheterization to prevent renal damage.
    • Early detection of detrusor overactivity enables anticholinergic treatment to preserve bladder capacity and compliance, preventing irreversible detrusor damage.