Vesicostomy revisited: the best treatment for the hostile bladder in myelodysplastic children?

Morrisroe, Shelby N.; O’Connor, R. Corey; Nanigian, Dana K.; Kurzrock, Eric A.; Stone, Anthony R.

doi:10.1111/j.1464-410x.2005.05638.x

Cited by 43 publications

(18 citation statements)

References 20 publications

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“…We found that early institution of CIC has almost completely prevented the evolution of nonrefluxing hydronephrosis in infants. For the rare infant with persistent hydronephrosis and/or high-grade reflux despite CIC, vesicostomy has been beneficial (20).…”

Section: Discussionmentioning

confidence: 99%

Renal Cortical Deterioration in Children With Spinal Dysraphism: Analysis of Risk Factors

DeLair

Eandi

White

et al. 2007

The Journal of Spinal Cord Medicine

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Background/Objective: Because hydronephrosis and reflux are reversible, we believe cortical loss represents true renal deterioration in children with spinal dysraphism. Our goal was to better define risk factors for cortical loss.Methods: After institutional review board approval, we reviewed the medical records of 272 children with spinal dysraphism. The following factors were evaluated: age, sex, renal and bladder imaging, urodynamic parameters, medications, catheterization program, continence, infections, and surgical history. Renal cortical loss was defined by scarring or a differential function greater than 15% using a nuclear scan. Univariate and multivariate logistic regression models were fitted to test the associations of specific variables with cortical loss.Results: Renal cortical loss was found in 41% of children with high-grade reflux vs 2% of children without reflux. Univariate analysis showed only high-grade reflux and female sex to be independent risk factors. Controlling for age and sex, reflux and initiation of catheterization after 1 year of age are significant risk factors. High bladder pressure and hydronephrosis in the absence of reflux were not associated with cortical loss. Multivariate analysis showed that girls with reflux have a 55-fold increased risk of cortical loss.Conclusion: By limiting the definition of renal deterioration to cortical loss, we identified relevant risk factors: reflux, female sex, and delayed initiation of clean intermittent catheterization. We have also discounted other suspected risk factors: hydronephrosis and elevated bladder pressure. Rather than continuing our focus on hydronephrosis and urodynamics, we believe more research and management debate should be afforded to females with reflux. Spinal Cord Med. 2007;30:S30-S34 J

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Section: Discussionmentioning

confidence: 99%

Renal Cortical Deterioration in Children With Spinal Dysraphism: Analysis of Risk Factors

DeLair

Eandi

White

et al. 2007

The Journal of Spinal Cord Medicine

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“…Since the publication of this pioneering article, many other studies have confirmed the risk of high bladder storage pressure to the upper tracts. The important question that must be posed is whether early intervention to manage the bladder can improve outcomes [Morrisroe et al 2005]. The answer is a resounding 'yes', as documented by the group at Boston Children's Hospital.…”

Section: Neurogenic Bladdermentioning

confidence: 99%

Best practice in the assessment of bladder function in infants

Guerra

Leonard

Castagnetti

2014

Therapeutic Advances in Urology

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Abstract:The purpose of this article is to review normal developmental bladder physiology in infants and bladder dysfunction in conditions such as neurogenic bladder, posterior urethral valves and high grade vesicoureteric reflux. We contrast the classical concept that bladder function in nontoilet-trained children is thought to be 'reflexive' or 'uninhibited', with the results of more recent research showing that infants most commonly have a stable detrusor. The infant bladder is physiologically distinct from the state seen in older children or adults. The voiding pattern of the infant is characterized by an interrupted voiding stream due to lack of proper urinary sphincter relaxation during voiding. This is called physiologic detrusor sphincter dyscoordination and is different from the pathologic 'detrusor sphincter dyssynergy' seen in patients with neurogenic bladder. Urodynamic abnormalities in neonates born with spina bifida are common and depend on the level and severity of the spinal cord malformation. Upper neuron lesions most commonly lead to an overactive bladder with or without detrusor sphincter dyssynergy while a lower neuron lesion is associated with an acontractile detrusor with possible denervation of the external urinary sphincter. In infants with neurogenic bladder, the role of 'early prophylactic treatment (clean intermittent catheterization and anticholinergics)' versus initial 'watchful waiting and treatment as needed' is still controversial and needs more research. Many urodynamic-based interventions have been suggested in patients with posterior urethral valves and are currently under scrutiny, but their impact on the long-term outcome of the upper and lower urinary tract is still unknown. Cumulative data suggest that there is no benefit to early intervention regarding bladder function in infants with high-grade vesicoureteric reflux.

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“…4 Shelby et al reported that complications, including stomal stenosis and bladder calculi, occurred in three of 15 children during a mean follow up of 7.4 years. 5 The authors stated that the complication rate was not high, and that stomal stenosis was easily treated with regular dilation. Their data and our results support the use of Blocksom vesicostomy in adult patients suffering from chronic urinary retention with severe physical or mental conditions.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Blocksom vesicostomy in elderly men with chronic urinary retention and severe dementia

Tobu

Noguchi

Kurata

et al. 2014

Geriatrics Gerontology Int

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Vesicostomy revisited: the best treatment for the hostile bladder in myelodysplastic children?

Cited by 43 publications

References 20 publications

Renal Cortical Deterioration in Children With Spinal Dysraphism: Analysis of Risk Factors

Renal Cortical Deterioration in Children With Spinal Dysraphism: Analysis of Risk Factors

Best practice in the assessment of bladder function in infants

Usefulness of Blocksom vesicostomy in elderly men with chronic urinary retention and severe dementia

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