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Published on: August 9, 2012

Renal preservation in children with neurogenic bladder-sphincter dysfunction followed in a national program

Peter Wide1, Gunilla Glad Mattsson, Sven Mattsson

  • 1Department of Experimental and Clinical Medicine, Division of Paediatrics, Linköping University, SE 581 85 Linköping, Sweden. peter.wide@lio.se

Journal of Pediatric Urology
|March 18, 2011
PubMed

Insights

High bladder pressure in children with neurogenic bladder-sphincter dysfunction (NBSD) is a key risk factor for kidney damage. Early, structured follow-up and treatment adherence are crucial for preventing renal scarring in these patients.

Area of Science:

  • Pediatric Urology
  • Nephrology
  • Developmental Pediatrics

Background:

  • Neurogenic bladder-sphincter dysfunction (NBSD) is a primary cause of morbidity in children with spina bifida.
  • Effective management of NBSD is critical to prevent secondary complications, particularly renal damage.

Purpose of the Study:

  • To identify risk factors associated with renal damage in children diagnosed with NBSD.
  • To evaluate the long-term outcomes of children with NBSD managed under Swedish national guidelines.

Main Methods:

  • Retrospective analysis of cystometry records for 41 children (aged 6-16 years) with NBSD.
  • Classification of children into high-pressure (baseline >30 cmH2O) and low-pressure groups based on bladder pressures during clean intermittent catheterization.
  • Evaluation of renal scarring using DMSA-scintigraphy.

Main Results:

  • Renal scarring was observed in 5 out of 41 children, with most maintaining normal renal function.
  • Higher incidence of renal scarring was significantly associated with the high-pressure group (P < 0.01).
  • Children with renal scars often presented with a combination of low bladder compliance and suboptimal treatment adherence.

Conclusions:

  • Elevated baseline bladder pressure is a confirmed risk factor for renal damage in pediatric NBSD.
  • Complex social factors can exacerbate challenges in managing NBSD and ensuring treatment compliance.
  • Structured, early follow-up and consistent treatment adherence are essential for preventing renal damage in children with NBSD.
Abstract

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