Related Experiment Videos
Neurogenic bladder in children: urodynamic studies and results with medical conservative treatment
C Gutierrez Segura1, J Teixidor de Otto
1Department of Pediatric Surgery, Children's Hospital, Hospital Univ. Covadonga, University of Oviedo, Spain.
Insights
Urodynamic findings guide treatment for pediatric neurogenic bladder, reducing infections and reflux. High bladder pressure and low urethral closure pressure indicate poorer outcomes in children.
Area of Science:
- Pediatric Urology
- Neurogenic Bladder Management
- Urodynamic Studies
Background:
- Neurogenic bladder affects children, leading to urinary issues like infections and vesicoureteral reflux.
- Urodynamic assessment is crucial for understanding bladder function in affected pediatric patients.
Purpose of the Study:
- To evaluate urodynamic findings and therapeutic outcomes in children with neurogenic bladder.
- To correlate specific urodynamic parameters with treatment success and disease progression.
Main Methods:
- Retrospective analysis of 25 children (2 months to 14 years) with neurogenic bladder.
- Urodynamic testing to assess bladder pressure, urethral closure pressure, and detrusor activity.
- Medical treatment guided by urodynamic results, including anticholinergic therapy.
Main Results:
- Medical treatment significantly reduced urinary infections and vesicoureteral refluxes.
- Higher pre-voiding bladder pressure (>50 cm H2O) correlated with worse outcomes.
- Lower urethral closure pressure (<47 cm H2O) indicated more challenging incontinence management.
- Anticholinergic treatment resolved hypertonia and hyperreflexia in 66.6% of cases.
- Continence was achieved in 37.5% and improved in 29.1% of children.
Conclusions:
- Urodynamic findings are essential for effective neurogenic bladder management in children.
- Specific urodynamic parameters can predict treatment response and prognosis.
- Tailored medical therapy, including anticholinergics, improves functional outcomes and continence in pediatric neurogenic bladder.
Abstract:
We present the urodynamic findings and therapeutic results in 25 children with neurogenic bladder, ranging in age from 2 months to 14 years. We observed a significant reduction of urinary infections and vesicoureteral refluxes following medical treatment based on the urodynamic findings. Furthermore, we observed a worse evolution in patients with pre-voiding bladder pressure in excess of 50 cm H2O, incontinence being more difficult to treat in children with urethral closure pressure profile below 47 cm H2O. In our series, anticholinergic treatment improved hypertonia and hyperreflexia which disappeared in 66.6% of cases. Total continence was achieved in 37.5% and improved in 29.1% of children.