Efficiency of Detrusor Chemodenervation With Botulinum Toxin in Combination With Conservative Therapy in a Child With Neurogenic Bladder and Myelodysplasia: A Clinical Case

Abstract

Dysfunction of the pelvic organs in children with myelodysplasia is a complex multifaceted problem. In some patients with long-term vesicoureteral reflux, as a complication of neurogenic bladder dysfunction, reflux nephropathy (RN) develops in a chronic kidney disease (CKD) outcome. One of the most effective as well as minimally invasive surgical interventions in this case is chemodenervation of the detrusor with botulinum toxin. This intervention in most cases not only improves the quality of life of patients, but also prevents further development of RN helping children to avoid traumatic augmentation surgery in the future. However, the duration of the chemodenervation effect is often insufficient. In the Authors’ opinion, synergistic conservative therapy aimed at improving regional blood circulation and correcting energy deficit is a must in order to improve the results. The result of the synergy of surgical and conservative treatment and their effectiveness are described in the presented clinical case observation.