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Urodynamic dysfunction in walking myelodysplastic children.

D P Dator1, L Hatchett, F M Dyro

  • 1Division of Urology, Children's Hospital, Boston, Massachusetts.

The Journal of Urology
|August 1, 1992
PubMed
Summary
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Children with myelodysplasia and low-level neurological deficits often experience urinary tract issues. Continuous monitoring and management are crucial for preventing deterioration and improving quality of life.

Area of Science:

  • Pediatric Urology
  • Neurogenic Bladder
  • Spinal Cord Abnormalities

Background:

  • Myelodysplasia often leads to neurogenic bladder dysfunction.
  • Neurological deficits at or below the S1 level can impact bladder and sphincter control.
  • Urinary tract complications are a significant concern in affected children.

Purpose of the Study:

  • To evaluate the urodynamic and radiological status of children with myelodysplasia and low-level neurological deficits.
  • To assess the progression of neurourological lesions and urinary tract complications over time.
  • To emphasize the importance of continuous surveillance and management strategies.

Main Methods:

  • Urodynamic and radiological evaluations were performed on 54 children.
  • Follow-up studies were conducted over periods ranging from 1 month to 10 years.

Related Experiment Videos

  • Management strategies included pharmacological agents, clean intermittent catheterization, and surgery.

    • Main Results:

    • Baseline urodynamic findings varied, with normal function in 24% and different types of motor neuron dysfunction in the rest.
    • Over half (54%) of the patients showed changes in their neurourological lesion during follow-up, with most deteriorating.
    • Urinary incontinence affected 75% of patients, and 37% (20 out of 54) had hydronephrosis and/or vesicoureteral reflux.

    Conclusions:

    • Urodynamic assessment provides a variable picture that may not correlate with neurological examination findings.
    • Children with myelodysplasia and low-level deficits are at risk for urinary tract deterioration.
    • Continuous surveillance and appropriate management are essential for optimizing outcomes in this pediatric population.