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Clean intermittent catheterization for home management in children with myelomeningocele
Insights
Clean intermittent catheterization (CIC) effectively manages neurogenic bladders in children with myelomeningocele. This safe method improved urinary control and stabilized upper urinary tracts in most patients, offering an alternative to surgery.
Area of Science:
- Pediatric Urology
- Nephrology
- Neurology
Background:
- Myelomeningocele frequently causes neurogenic bladders, leading to urinary dysfunction and potential renal damage.
- Management of neurogenic bladders in children requires effective bladder emptying strategies to prevent complications.
Purpose of the Study:
- To evaluate the efficacy and safety of clean intermittent catheterization (CIC) in managing children with myelomeningocele and neurogenic bladders.
- To assess the impact of CIC on upper urinary tract status and urinary control.
Main Methods:
- A cohort of 62 children with myelomeningocele and neurogenic bladders were managed with home-based CIC.
- Patients were monitored for 6 to 42 months, assessing upper urinary tract changes, renal function, bacteriuria, and urinary control.
Main Results:
- 83% of children showed improvement or stabilization of abnormal upper urinary tracts.
- No renal deterioration was observed in children with initially normal upper tracts on CIC.
- 66% of children experienced improved urinary control, and bacteriuria was generally not clinically significant unless ureterovesical reflux was present.
Conclusions:
- Clean intermittent catheterization (CIC) is a safe and effective method for bladder management in children with neurogenic bladders.
- CIC offers a viable alternative to supravesical urinary diversion, improving renal outcomes and urinary control.
Abstract:
Sixty-two children with myelomeningocele and neurogenic bladders have been managed with clean intermittent catheterization (CIC) at home for periods of 6 to 42 months. Abnormal upper urinary tracts improved or stabilized in 83 per cent of the children. There was no renal deterioration in children who began with normal upper tracts while on CIC. Bacteruria was common, but clinically not a problem, unless ureterovesical reflux was present. Urinary control was improved in 66 per cent of the children. CIC is an effective and safe method to regularly empty the urinary bladder and is an alternative to supravesical urinary diversion in many children with neurogenic bladders.