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[The urethrogram in children with neurogenic bladder dysfunction (author's transl)].

H Maderbacher, G Stampfel

    Rofo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin
    |August 1, 1977
    PubMed
    Summary
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    Micturition cystourethrography reveals distinct patterns in children with neurogenic bladder dysfunction, aiding in diagnosis. These changes can mimic other conditions, highlighting the importance of accurate interpretation for effective treatment.

    Area of Science:

    • Pediatric Urology
    • Neurourology
    • Radiology

    Background:

    • Neurogenic bladder dysfunction in children presents with varied micturition cystourethrogram (MCUG) findings.
    • Understanding these characteristic changes is crucial for diagnosing and managing urinary tract abnormalities.
    • Functional urethral obstruction can arise from spastic or paretic pelvic floor dysfunction, impacting bladder emptying.

    Purpose of the Study:

    • To describe the characteristic micturition cystourethrogram findings in different types of pediatric neurogenic bladder dysfunction.
    • To highlight the diagnostic challenges, including differentiating from urethral valves and identifying occult neurogenic bladders.

    Main Methods:

    • Retrospective analysis of micturition cystourethrograms in children diagnosed with neurogenic bladder dysfunction.

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  • Correlation of radiographic findings with clinical presentation and urodynamic data.

    • Main Results:

    • Reflex bladder: characterized by urethral narrowing at the pelvic floor.
    • Autonomous bladder: shows an elongated, deformed, and angled urethra due to low bladder position during straining or Credé maneuver.
    • Functional obstruction can lead to morphological changes in both lower and upper urinary tracts.

    Conclusions:

    • Micturition cystourethrograms provide valuable insights into the specific types of neurogenic bladder dysfunction in children.
    • Radiographic appearances can sometimes mimic urethral valves, necessitating careful evaluation.
    • Occult neurogenic bladder presents diagnostic difficulties that require a high index of suspicion.