Related Experiment Videos
Management of pediatric neurogenic bladder
1Department of Urology, Dalhousie University, Halifax, Nova Scotia, Canada. Dawn.MacLellan@iwk.nshealth.ca
Current Opinion in Urology
|May 15, 2009
Summary
Current literature reviews neurogenic bladder management in children, highlighting ultrasound for risk assessment and promising new treatments. Long-term data is needed to confirm efficacy and address future care challenges.
Area of Science:
- Pediatric Urology
- Neuroscience
- Nephrology
Background:
- Neurogenic bladder in children presents complex management challenges.
- Upper urinary tract deterioration is a significant concern.
Purpose of the Study:
- To review current literature on managing neurogenic bladder in pediatric patients.
- To identify recent advancements and ongoing challenges in the field.
Main Methods:
- Literature review of recent publications on neurogenic bladder in children.
- Analysis of diagnostic tools and therapeutic strategies.
Main Results:
- Ultrasound measurement of bladder wall thickness may predict urodynamic risk factors for upper urinary tract damage.
- Promising management strategies include maximal anticholinergic therapy, endoscopic procedures, conservative approaches, and isolated bladder neck procedures.
- Long-term follow-up data is currently insufficient for widespread adoption of all novel strategies.
Conclusions:
- Pediatric urologists face challenges in predicting upper urinary tract deterioration, avoiding bladder augmentation, and ensuring long-term care.
- Newer literature addresses these issues, but further prospective studies with extended follow-up are essential.
- Optimizing continence and preserving renal function in children with neurogenic bladder requires continued research and evidence-based strategies.
Related Concept Videos
01:26The Micturition Reflex
Urination, or micturition involves the coordination of the bladder's detrusor muscle and two sphincters to ensure controlled bladder emptying.
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating urine...
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating urine...
01:17Urinary Tract Infection IV: Nursing Management
In managing urinary tract infections (UTIs) in nursing, a comprehensive assessment is essential. Begin by gathering subjective data, such as the patient’s complaints of dysuria (painful urination), urinary frequency, urgency, suprapubic pain, and any lower abdominal discomfort. This information can be complemented by questions regarding previous UTIs, sexual activity, and personal hygiene practices, which can provide insight into risk factors. Objective assessment should focus on signs like...
01:28Urinary Tract Calculi V: Nursing Management
AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
01:23Urinary Bladder
The urinary bladder is a hollow, muscular sac that temporarily stores urine before it is expelled from the body. It can hold approximately 600 mL of urine prior to micturition. The bladder is retroperitoneal and located behind the pubic symphysis in the pelvic floor.
In males, the bladder is situated in front of the rectum, while in females, it is positioned anterior to the vagina and uterus. The bladder floor contains an inverted triangular area called the trigone, defined by the two ureteric...
In males, the bladder is situated in front of the rectum, while in females, it is positioned anterior to the vagina and uterus. The bladder floor contains an inverted triangular area called the trigone, defined by the two ureteric...
01:21Nursing Assessment of the Genitourinary System I: Health History
The genitourinary system is critical to maintaining fluid balance, waste elimination, and reproductive function. Nurses play a vital role in assessing this system, beginning with a thorough health history. This process involves gathering patient information, identifying risk factors, and recognizing symptoms of genitourinary disorders. Early detection is vital for timely interventions and management.1. Gathering Patient InformationA complete health history includes the patient’s personal,...