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The management of vesicoureteral reflux in the pediatric neurogenic bladder
Insights
Management of neurogenic bladder and reflux in children varies. Ureteroneocystostomy offered the best reflux resolution, but conservative methods also showed success in preventing upper tract damage.
Area of Science:
- Pediatric Urology
- Nephrology
- Pediatric Surgery
Background:
- Neurogenic bladder and vesicoureteral reflux are common in children.
- Effective management is crucial to prevent upper urinary tract deterioration.
Purpose of the Study:
- To evaluate an integrated management method for pediatric neurogenic bladder with vesicoureteral reflux.
- To compare the efficacy of different management strategies.
Main Methods:
- Retrospective analysis of 29 children with neurogenic bladder and vesicoureteral reflux.
- Management strategies included observation, intermittent catheterization, vesicostomy, and ureteroneocystostomy.
- Radiological follow-up assessed reflux resolution and upper tract status.
Main Results:
- Reflux resolution rates were 48% with observation, 48% with catheterization, 75% with vesicostomy, and 100% with ureteroneocystostomy.
- Conservative management and ureteroneocystostomy were effective in preventing upper tract damage.
Conclusions:
- Integrated management approaches are effective for pediatric neurogenic bladder and reflux.
- Both conservative and surgical interventions can successfully manage reflux and protect renal units.
Abstract:
An integrated method of management has been used in 29 children with neurogenic bladders and vesicoureteral reflux. Radiological followup reveals that resolution or improvement of reflux occurred in 48 per cent of the renal units managed by close observation only, 48 per cent managed by intermittent catheterization, 75 per cent managed by vesicostomies and 100 per cent in which the ureters were reimplanted. As in the non-neurogenic bladder successful management of reflux and prevention of upper tract deterioration can be achieved by conservative management as well as by ureteroneocystostomy. A protocol of management is outlined.