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[Vesico-ureteral reflux in patients with neurogenic bladder dysfunction: causes, types, treatment, development and
J Rodó Salas1, J M Costa, J Escolá
1Unidad de Espinas Bifidas, Hospital San Juan de Dios, Barcelona.
Insights
Vesicoureteral reflux in children with neurogenic bladder dysfunction can be effectively managed. Treatment strategies, including medical management and intermittent catheterization, showed satisfactory outcomes in most cases.
Area of Science:
- Pediatric Urology
- Neurology
- Nephrology
Context:
- Neurogenic bladder dysfunction affects children, often leading to complications like vesicoureteral reflux.
- Vesicoureteral reflux (VUR) is a significant concern in pediatric patients with neurogenic bladder.
- This study focuses on VUR management within a cohort of 106 children with neurogenic bladder.
Purpose:
- To analyze the outcomes of different treatment modalities for vesicoureteral reflux in children with neurogenic bladder dysfunction.
- To evaluate the efficacy of medical management, intermittent catheterization, and surgical interventions for VUR in this specific patient group.
Summary:
- Thirty-one pediatric patients with neurogenic bladder dysfunction and vesicoureteral reflux were treated.
- Treatment approaches included medical management, intermittent catheterization, and surgery.
- Satisfactory outcomes (cure or improvement) were observed in 35 out of 47 affected ureteral units.
Impact:
- Demonstrates the effectiveness of tailored treatment strategies for vesicoureteral reflux in children with neurogenic bladder.
- Provides insights into managing VUR, a common complication, thereby potentially improving renal outcomes.
- Highlights the importance of appropriate management to prevent long-term renal damage in affected children.
Abstract:
Thirty one patients, suffering from vesicoureteral reflux, were selected from a group of 106 children affected by neurogenic bladder dysfunction. The causes of neurogenic dysfunction (26 a sequel of spina bifida, 2 agenesis of sacrum and 3 medullar tumors) and grade and type of reflux in the 47 reno-ureteral units (I, 4; II, 20; III, 6; IV, 11, and V, 6) are described. The treatment was medical, combining different bladder expression methods, in 11 ureters, medical plus intermittent catheterization in 36 and surgical in 14. The analysis of the results were: Satisfactory because of complete cure or improvement of the reflux in 35 ureters, un satisfactory in 5 (3 patient died and 2 were diverted and indeterminate in the other 7, whose reflux remained unchanged whose follow up was too short.