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Urinary catheters in spina bifida
Summary
Catheterization for neuropathic bladder in children yielded good results in 70% of girls and 50% of boys. Vesico-ureteric reflux is a relative contraindication, especially without severe disabilities.
Area of Science:
- Pediatric Urology
- Nephrology
- Neurology
Background:
- Neuropathic bladder affects children, leading to incontinence and potential kidney damage.
- Catheterization is a management option for these complex cases.
Purpose of the Study:
- To evaluate the efficacy and safety of intermittent or indwelling catheterization in children with neuropathic bladder.
- To identify factors influencing outcomes and contraindications for catheterization.
Main Methods:
- Retrospective analysis of 56 children with neuropathic bladder managed with catheterization since 1974.
- Indications included incontinence, hydronephrosis, and difficulty with bladder expression.
Main Results:
- Successful catheterization in 70% of girls and 50% of boys.
- Catheter abandonment in 7 children due to parental non-compliance.
- Upper tract deterioration occurred in 33% of children with pre-existing hydronephrosis and vesico-ureteric reflux.
Conclusions:
- Catheterization is effective for neuropathic bladder in children, though outcomes vary by sex.
- Vesico-ureteric reflux is a relative contraindication, particularly when upper tract deterioration is a risk.
- Perineal urethrostomy may be a viable alternative for specific patient groups.