Urinary Continence in Children with Neurogenic Bladders

Kaye, Keith W.; Blerk, P. J. P. Van

doi:10.1111/j.1464-410x.1981.tb06096.x

Cited by 4 publications

(1 citation statement)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The most widely used methods in surveillance of the upper urinary tract and bladder dysfunction are ultrasonography, renography and urodynamics in the imaging of the urinary tract and kidneys, and a description of the bladder function, respectively. The latter investigation has been used for early identification of children at high risk of kidney function deterioration caused by the NBD and, later in childhood, to obtain the necessary knowledge regarding the appropriate strategy for treatment of incontinence [2,3,7,8]. In the NBD, four main combinations of overactive/underactive detrusor and sphincter function exist [9].…”

Section: Introductionmentioning

confidence: 99%

Urological outcome after myelomeningocele: 20 years of follow‐up

2010

View full text Add to dashboard Cite

Study Type – Therapy (case series) Level of Evidence 4 What’s known on the subject? and What does the study add? Although treatment modalities have improved over the years, long‐term follow‐up studies on the myelomeningocele population still include a high proportion of patients with urological complications such as impairment of kidney function and urinary incontinence. In selected consecutive material, our study could relate the urological outcome of adults to urodynamic variables performed in childhood 20 years before. OBJECTIVE • To evaluate the urological outcome in a long‐term follow‐up of individuals with myelomeningocele and relate the findings obtained to urodynamic variables in childhood. PATIENTS AND METHODS • Individuals with myelomeningocele born from 1964–1988 were included at time of urodynamic investigation. • Age at inclusion was in the range from 1 month to 19.5 years (median, 6 years). • Detrusor function was classified as overactive, underactive or non‐contractile. • Urethral function was classified according to the leak point pressure. • In childhood and at follow‐up, kidney function was estimated with renography and isotope‐glomerular filtration rate examinations. RESULTS • In total, 52 individuals (28 boys and 24 girls) aged 19–41 years (median, 29 years) had follow‐up. • Of these, 37 (71%) individuals had bilateral normal kidney function at follow‐up; seven (14%) had normal total renal function but unilateral deteriorated kidney, and eight individuals (15%) had deteriorated kidney function. • Adult individuals with bilateral kidney deterioration had a significant higher frequency of diagnosed detrusor overactivity at childhood urodynamics (63%) compared to those with normal function of both kidneys (24%). In total, 48% of the 52 myelomeningocele individuals were continent at follow‐up. • Continence surgery was performed in eight patients, nine used anticholinergica, three had regular botulinum toxin detrusor injections, and 27 used clean intermittent catheterization. CONCLUSIONS • Overall, 15% of patients had impairment of kidney function and 48% were urinary continent. • Considering the present age distribution of the present study population, this figure appears to be comparable to the data in the literature. • Urodynamic findings in childhood were predictive for later kidney deterioration.

show abstract

Section: Introductionmentioning

confidence: 99%

Urological outcome after myelomeningocele: 20 years of follow‐up

2010

View full text Add to dashboard Cite

show abstract

Neurogenic vesico-urethral dysfunction in children with cerebral palsy

et al. 1988

View full text Add to dashboard Cite

20 children with severe cerebral palsy and history of urinary incontinence and recurrent urinary infection underwent radio--and neuro-urologic evaluation. Vesico-ureteral reflux was found in 7 patients. In 9, who had presented episodes of urine sub-retention, a urodynamic study demonstrated detrusor muscle hyperreflexia in all, deficit of vesicourethral sensation in 5 and detrusor-sphincter dyssynergia in 2. These functional findings are compatible with an upper motor neuron lesion, and may be the cause of episodes of altered bladder emptying, and consequently, urinary infection.

show abstract

Neuropathic bladder and intermittent catheterization: social and psychological impact on families

Borzyskowski

Cox

Edwards³

et al. 2004

Dev Med Child Neurol

View full text Add to dashboard Cite

Clean intermittent catheterization (CIC) is the mainstay of management in neuropathic vesicourethral dysfunction, both to improve continence and, more importantly, to preserve renal function. We looked at the effects of this procedure on children, adolescents, and their families. In particular, we wished to see if there were any differences between those who successfully catheterized and those who did not. Forty families were enrolled into the study. Ages of children and adolescents (23 females, 17 males) ranged from 1 to 20 years. Most participants (n=31) had spina bifida. Other causes of bladder dysfunction included transverse myelitis, spinal cord injury, and spinal neuroblastoma. Parents were assessed using the Effects of Handicap on Parents semi-structured interview, the Socioemotional Functioning Interview, and a semi-structured interview, specifically designed for the study, which looked at family characteristics and experience related to diagnosis and catheterization. In addition, the Rutter Parental 'A' Scale Questionnaire was used to screen for emotional and behavioural disorders in the child. Results showed that CIC by carer or self-catheterization itself did not cause major emotional and behavioural problems but the bladder problem may act as a focus that puts considerable strain family relationships. Although most parents disliked CIC they complied with the suggested management. It is important that all those involved understand the aims of management and success can be achieved by combined input from medical, psychological, and specialist nursing staff. The problem is lifelong and continued support from a multidisciplinary team is essential.

show abstract

Urinary Continence in Children with Neurogenic Bladders

Cited by 4 publications

References 18 publications

Urological outcome after myelomeningocele: 20 years of follow‐up

Urological outcome after myelomeningocele: 20 years of follow‐up

Neurogenic vesico-urethral dysfunction in children with cerebral palsy

Neuropathic bladder and intermittent catheterization: social and psychological impact on families

Contact Info

Product

Resources

About