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Is there an association between functional bladder outlet obstruction and Down's syndrome?
J A Hicks1, C Carson, P S J Malone
1Department of Paediatric Nephro-Urology, Southampton University Hospitals NHS Trust, Southampton, UK.
Journal of Pediatric Urology
|October 25, 2008
Summary
Patients with Down syndrome (DS) often experience bladder dysfunction, leading to potential renal injury. Early assessment of bladder function and urinary tract ultrasounds are recommended for children with DS.
Area of Science:
- Urology
- Pediatrics
- Genetics
Background:
- Urinary tract abnormalities affect 3-7% of individuals with Down syndrome (DS).
- Reported abnormalities include renal hypoplasia, cysts, and ureteropelvic junction obstruction.
- An association between males with DS and non-neurogenic neurogenic bladder has been noted.
Purpose of the Study:
- To test the hypothesis that patients with DS experience functional bladder outflow obstruction due to detrusor sphincter dyssynergia.
- To assess the incidence and types of bladder dysfunction in patients with DS.
Main Methods:
- A three-part study involving retrospective case note review, a prospective community-based assessment, and a hospital-based evaluation.
- Retrospective review of existing patients' case notes.
- Prospective community-based study and hospital-based assessment following questionnaire return.
Main Results:
- Retrospective review revealed significant renal injury potential, with 3/7 patients needing urinary diversion for obstruction-related upper tract dilation.
- Prospective study found a high incidence (77%) of bladder dysfunction among patients with DS.
- A history of wetting was reported in 68% of patients with DS.
Conclusions:
- Bladder dysfunction in children with Down syndrome is a serious, underappreciated issue.
- Recommendations include taking detailed bladder function histories for all children with DS.
- Urinary tract ultrasound scans are advised for those with detected bladder problems.
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