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The unrecognized neuropathic bladder of infancy
The Journal of Urology
|August 1, 1989
Summary
Four infants with hydroureteronephrosis experienced bladder emptying issues due to detrusor-sphincter dyssynergia. This persistent neurourological disturbance may stem from perinatal brainstem insults.
Area of Science:
- Pediatric Urology
- Neuro-urology
- Developmental Pediatrics
Background:
- Detrusor-sphincter dyssynergia (DSD) can cause significant urinary tract issues in infants.
- Neurological dysfunction is often associated with DSD, but atypical presentations occur.
Purpose of the Study:
- To describe a cohort of infants with hydroureteronephrosis and DSD without overt neurological signs.
- To investigate the potential link between perinatal insults and DSD in this population.
- To report long-term urodynamic outcomes.
Main Methods:
- Case series of four infants presenting with hydroureteronephrosis and incomplete bladder emptying.
- Clinical evaluation excluding other neurological deficits.
- Long-term urodynamic follow-up.
Main Results:
- All four infants exhibited DSD leading to incomplete bladder emptying and hydroureteronephrosis.
- No patients showed other signs of neurological dysfunction.
- Long-term follow-up revealed persistent, nonprogressive neurourological disturbances.
Conclusions:
- Infants can present with DSD and hydroureteronephrosis without apparent neurological deficits.
- A perinatal brainstem insult is a potential, though unproven, cause.
- These cases highlight a specific neurourological disturbance requiring long-term monitoring.