Related Experiment Videos
Neuropathic vesicourethral dysfunction in children. A trial comparing clean intermittent catheterisation with manual
Insights
Clean intermittent catheterisation (CIC) significantly improved continence in children with neurological disease and neuropathic bladder compared to non-CIC methods. However, neither treatment prevented renal function decline or improved severe bladder dysfunction.
Area of Science:
- Pediatric Urology
- Neurology
- Nephrology
Background:
- Neuropathic vesicourethral dysfunction affects children with neurological diseases.
- Management options include clean intermittent catheterisation (CIC) and non-CIC methods (manual expression with drugs).
- Assessing treatment efficacy for continence and renal function is crucial.
Purpose of the Study:
- To compare the effectiveness of CIC versus non-CIC treatments.
- To evaluate the impact of these treatments on continence and renal function.
- To identify limitations of current treatments in specific pediatric patient groups.
Main Methods:
- A trial involving 43 children with neurological disease and neuropathic vesicourethral dysfunction.
- Comparison between a group using CIC (22 children) and a group using non-CIC (21 children).
- Assessment of continence improvement and urinary tract infection incidence.
Main Results:
- CIC group showed significantly greater improvement in continence (P < 0.001).
- No significant increase in urinary tract infections observed in the CIC group.
- Neither treatment prevented renal function deterioration in cases of detrusor-sphincter dyssynergia with vesicoureteric reflux.
Conclusions:
- Clean intermittent catheterisation is more effective for improving continence in this population.
- Current treatments do not prevent renal deterioration in complex cases.
- Severe bladder compliance issues or sphincter weakness limit treatment efficacy for continence.
Abstract:
Forty-three children with overt neurological disease and neuropathic vesicourethral dysfunction were entered into a trial comparing clean intermittent catheterisation (CIC) with manual expression combined with drug treatment (non-CIC). The 22 children in the CIC group showed a significantly greater improvement in continence than the 21 children in the non-CIC group (P less than 0.001) without a significant increase in the incidence of urinary tract infections. Neither form of treatment is effective in reducing the risk of deterioration of renal function due to the combination of detrusor-sphincter dyssynergia and vesicoureteric reflux. Neither form of treatment improves continence in the presence of gross sphincter weakness or gross impairment of bladder compliance.