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The rationale for bladder washouts in children with neurogenic bladder
Gopal-Krsna Singh1, Aniruddh V Deshpande2,3,4,5, Gemma Schlegel5
1Department of Paediatrics, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
Insights
Neurogenic bladder in children can lead to frequent urinary tract infections and kidney damage. Bladder washouts using electrochemically activated solutions offer a novel, non-antibiotic approach to prevent chronic bacteriuria in these high-risk patients.
Area of Science:
- Pediatric Urology
- Nephrology
- Infectious Diseases
Background:
- Children with neurogenic bladder face risks of recurrent urinary tract infections (UTIs) and kidney failure.
- Altered lower urinary tract function can lead to misdiagnosis and inappropriate treatment of UTIs.
- These patients are frequent healthcare users, susceptible to antibiotic resistance due to frequent interventions.
Purpose of the Study:
- To explore electrochemically activated solutions as a non-antibiotic prophylactic option for bladder dysfunction.
- To address chronic bacteriuria in children undergoing clean intermittent catheterization.
- To reduce the incidence of UTIs and subsequent complications in this vulnerable population.
Main Methods:
- Utilized non-antibiotic electrochemically activated solutions for bladder washouts.
- Applied the intervention in pediatric patients with neurogenic bladder and chronic bacteriuria.
- Focused on patients where clean intermittent catheterization had previously resulted in persistent bacteriuria.
Main Results:
- Electrolyzed solutions demonstrated potential as a prophylactic agent.
- This approach offers an alternative to antibiotic therapy for managing chronic bacteriuria.
- The study highlights a novel strategy for bladder dysfunction management.
Conclusions:
- Bladder washouts with electrochemically activated solutions present a promising new prophylactic strategy.
- This method may help prevent chronic bacteriuria in children with neurogenic bladder dysfunction.
- It offers a potential solution to mitigate antibiotic resistance concerns in this patient group.
Abstract:
Children with a neurogenic bladder are at risk of developing recurrent urinary tract infections and long-term kidney failure. Due to an altered lower urinary tract, children may be overtreated for simple bacteriuria or undertreated for a potentially severe urinary tract infection. This group of patients represent high users of healthcare, and are at risk of colonization and development of antibiotic resistance. Bladder washouts with non-antibiotic electrochemically activated solutions are a potential new prophylactic option for patients with bladder dysfunction when clean intermittent catheterization has resulted in chronic bacteriuria.
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