Neuropathic bladders: Investigation and treatment through their lifetime

Abstract

The child with a neuropathic bladder requires lifelong dedicated care. Just as each patient presents with unique physiology, each phase of their life presents varying challenges. The primary concern for our patients is their renal health, but continence and independence also play significant roles. Most patients can be managed conservatively, but a myriad of surgical options are also available, reinforcing our emphasis on individualized care. Appropriate presurgical planning is required to ensure the right patient receives the best operation for his/her wants and needs. Furthermore, the numerous potential complications must be understood and longterm followup and surveillance is required.This review outlines the basic pathophysiology, investigations, and treatments, with a focus on the changing needs throughout their lives.

Long-term Safety and Tolerability of Repeated Treatments With OnabotulinumtoxinA in Children With Neurogenic Detrusor Overactivity

“…3,4 Spina bifida is estimated to occur in 1 per 1,000 births worldwide but prevalence varies by country, 5 and accounts for approximately 90% of cases of neurogenic bladder, 3,6 with most patients required to practice clean intermittent catheterization on a lifelong basis. 7,8 The goals in the management of pediatric NDO are to attain and maintain safe bladder storage pressures and bladder capacities to prevent permanent damage to the bladder, ureters, and kidneys, and to maintain urinary continence. OnabotulinumtoxinA 200 U is a well-tolerated and effective treatment option that was approved in 2011 for adults with UI due to NDO inadequately controlled with anticholinergic therapy.…”

“…3,4 Spina bifida is estimated to occur in 1 per 1,000 births worldwide but prevalence varies by country, 5 and accounts for approximately 90% of cases of neurogenic bladder, 3,6 with most patients required to practice clean intermittent catheterization on a lifelong basis. 7,8…”