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Neurovesical dysfunction in children after treating pelvic neoplasms
G Mosiello1, C Gatti, M De Gennaro
1Paediatric Surgery Department, Bambino Gesù Children's Hospital, Rome, Italy. mosiello@opbg.net
BJU International
|July 31, 2003
Summary
Surgery for pediatric pelvic neoplasms can cause neurogenic lower urinary tract dysfunction due to nerve damage. Early detection and management are crucial for improving outcomes in affected children.
Area of Science:
- Pediatric Urology
- Pediatric Oncology
- Neuro-oncology
Background:
- Pelvic neoplasms in children can lead to neurogenic lower urinary tract dysfunction (NLUTD).
- Understanding the causes and occurrence of NLUTD post-surgery is vital for patient management.
Purpose of the Study:
- To evaluate 10 years of surgical experience with pediatric pelvic neoplasms.
- To define the occurrence and causes of NLUTD following such surgeries.
Main Methods:
- Retrospective analysis of 33 children operated for pelvic neoplasms (1991-2000).
- Detailed urological and neurological assessment of 11 selected patients, including urodynamics and MRI.
- Categorization of patients based on surgical approach and tumor location.
Main Results:
- Eight of 11 analyzed children exhibited bladder sphincter dysfunction.
- Neurogenic damage was identified in two children, linked to spinal dysraphism and surgical nerve injury.
- Patients with paraspinal tumors showed more bladder dysfunction, potentially due to transient or incomplete nerve injury.
Conclusions:
- Surgical trauma in pelvic neoplasm treatment can cause bladder and urethral innervation deficits.
- Tethered cord syndrome in sacrococcygeal teratoma (ST) may lead to mixed neurogenic damage.
- Knowledge from managing voiding dysfunction in other pediatric conditions aids understanding of neoplasm-related NLUTD.