Voiding dysfunction in children causes, management, and prognosis: A single-center retrospective study

Area of Science:

• Pediatric Urology
• Nephrology
• Pediatric Surgery

Background:

• Voiding dysfunction in children presents significant challenges.
• Understanding the impact of different etiologies like dysfunction voiding syndrome (DVS), neurogenic bladder (NB), and valve bladder syndrome (VBS) is crucial for patient outcomes.
• Comorbidities associated with voiding dysfunction can severely impact renal function.

Purpose of the Study:

• To review voiding dysfunction in children across three distinct etiologies: DVS, NB, and VBS.
• To analyze the impact of management strategies and comorbidities on renal function.
• To correlate age at presentation with long-term renal outcomes.

Main Methods:

• A retrospective single-center study of 199 children with voiding dysfunction from 2005 to 2017.
• Patients were categorized into DVS, NB, and VBS groups.
• Data analysis included management types, comorbidities, urodynamic findings, and estimated glomerular filtration rate (eGFR) changes.

Main Results:

• Significant comorbidities like hydronephrosis and vesicoureteral reflux were common, negatively impacting eGFR.
• Poor bladder compliance was observed in 57.6% of patients, with 22% progressing to chronic kidney disease.
• While overall eGFR improved, the valve bladder syndrome (VBS) group showed the least improvement, and older age at presentation correlated with lower eGFR.

Conclusions:

• Early diagnosis and management of childhood voiding dysfunction are associated with better renal prognosis.
• Conservative management strategies appear to preserve kidney function more effectively than surgical interventions.
• Timely intervention is critical for optimizing long-term renal outcomes in pediatric voiding dysfunction.