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Bladder instability and upper renal tract damage.

Abbas Abdul Aal1, Ayman Khalil

  • 1Salmania Medical Complex, P.O. Box.12, Manama, Bahrain.

Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia
|July 24, 2007
PubMed
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Bladder instability in children, often mistaken for neurogenic bladder disease, is effectively managed with anticholinergic therapy and antibiotic prophylaxis. Early recognition and treatment lead to complete remission, preventing potential kidney damage and unnecessary procedures.

Area of Science:

  • Pediatric Urology
  • Pediatric Nephrology
  • Pediatric Gastroenterology

Background:

  • Bladder instability is a common cause of dysfunctional voiding in children.
  • It can mimic symptoms of neurogenic bladder disease.
  • This condition affects voiding function and can lead to complications.

Purpose of the Study:

  • To investigate the characteristics and management of bladder instability in children.
  • To evaluate the effectiveness of non-surgical interventions.
  • To highlight the importance of accurate diagnosis to prevent complications.

Main Methods:

  • A retrospective study of 100 children diagnosed with bladder instability over five years.
  • Analysis of clinical presentation, ultrasound findings, and treatment outcomes.

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  • Patients received anticholinergic therapy and antibiotic prophylaxis.

    • Main Results:

    • Peak incidence observed in children aged 4-8 years, with a female predominance (3:2 ratio).
    • Common symptoms included urgency, urge incontinence (80%), recurrent cystitis (50%), and nocturnal enuresis (40%).
    • Ultrasound revealed bladder wall thickening and significant residual urine; all patients achieved remission with medical management.

    Conclusions:

    • Early recognition of bladder instability is crucial for successful pediatric voiding dysfunction management.
    • Non-surgical treatment with anticholinergic therapy and antibiotic prophylaxis is highly effective.
    • Accurate diagnosis prevents unnecessary investigations, surgical procedures, and potential upper renal damage.