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Long-term results of obstructive neurogenic bladder in children with myelomeningocele
Insights
Children with myelomeningocele and neurogenic bladder face increasing risks of subvesical obstruction. Early detection and management are crucial for long-term urinary tract health.
Area of Science:
- Pediatric Urology
- Neurogenic Bladder Management
- Spina Bifida Research
Background:
- Myelomeningocele frequently results in neurogenic bladder dysfunction.
- Urinary tract complications, including obstruction, pose significant risks in these children.
Purpose of the Study:
- To investigate the long-term progression of subvesical obstruction in children with myelomeningocele and neurogenic bladder.
- To identify predictors for conservative management success.
Main Methods:
- Longitudinal follow-up of 91 children with myelomeningocele and neurogenic bladder for 5-10 years.
- Serial investigations of upper and lower urinary tracts at 3 months, 5 years, and 10 years of age.
Main Results:
- Subvesical obstruction was uncommon in infancy but increased with age.
- By age five, 50% of children exhibited severe obstructive changes.
- Delayed onset of severe obstruction is associated with better conservative treatment outcomes.
Conclusions:
- Progressive subvesical obstruction is a common and increasing complication in children with neurogenic bladder.
- Children reaching 5-6 years without severe obstruction have a favorable prognosis for conservative management.
Abstract:
A total of 91 children with myelomeningocele and neurogenic bladder were followed up for periods of between five and 10 years. The results of investigations of the upper and lower urinary tracts at the ages of three months, five years and 10 years showed that subvesical obstruction was rare in the infant period but that it increased year by year as the children grew older. By the age of five years 50 per cent of the children in this sample had severe obstructive changes. The study shows that children with neurogenic bladder who reach five or six years of age without developing severe symptoms of progressive subvesical obstruction will stand a good chance of being able to be treated conservatively.