Lower urinary tract dysfunction in children with central nervous system tumours

Area of Science:

• Pediatric Neurology
• Urology
• Oncology

Background:

• Central nervous system (CNS) tumors are a significant concern in pediatric oncology.
• Neuropathic vesicourethral dysfunction can be a debilitating complication in children with CNS tumors.
• Early identification and management of bladder dysfunction are crucial for improving quality of life.

Purpose of the Study:

• To present findings on neuropathic vesicourethral dysfunction in children with CNS tumors.
• To correlate tumor location and type with specific bladder dysfunctions.
• To discuss management strategies based on videourodynamics (VUD) findings.

Main Methods:

• Retrospective analysis of 10 children with CNS tumors and vesicourethral dysfunction.
• Detailed clinical history, neurological examination, and videourodynamics (VUD) assessment.
• Correlation of VUD findings with tumor characteristics and location.

Main Results:

• Eight children had spinal tumors, and two had brainstem tumors.
• Bladder dysfunction typically occurred late, except in cases with conus/cauda equina involvement.
• Tumor recurrence was often preceded by loss of bladder control.
• VUD revealed diverse "filling" and "voiding" dysfunctions based on tumor location (pons to cauda equina).
• A suprapontine tumor was associated with isolated "filling" dysfunction.

Conclusions:

• CNS tumors can lead to significant neuropathic vesicourethral dysfunction in children.
• Loss of bladder control can be an early indicator of tumor recurrence.
• VUD is essential for characterizing bladder dysfunction and guiding management strategies.
• Effective management improves the quality of life for affected children and their families.