Treatment Outcome of Neurogenic Bladder Dysfunction in Children; A Five-Year Experience

Fathollah  Roshanzamir; Mohsen  Rouzrokh; Alireza  Mirshemirani; Ahmad  Khaleghnejad; Leila  Mohajerzadeh; Reza  Dalirani

IJ Pediatrics

The Scientific Journal of Growth & Development Research Center

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Treatment Outcome of Neurogenic Bladder Dysfunction in Children; A Five-Year Experience

Author(s):

Fathollah Roshanzamir¹,

Mohsen Rouzrokh^2,*,

Alireza Mirshemirani³,

Ahmad Khaleghnejad⁴,

Leila Mohajerzadeh⁵,

Reza Dalirani⁶

IJ Pediatrics:Vol. 24, issue 3; 323-326

Published online:May 08, 2014

Article type:Brief Report

Received:Nov 10, 2013

Accepted:Feb 25, 2014

How to Cite:Fathollah RoshanzamirMohsen RouzrokhAlireza MirshemiraniAhmad KhaleghnejadLeila MohajerzadehReza Daliraniet al.Treatment Outcome of Neurogenic Bladder Dysfunction in Children; A Five-Year Experience.Iran J Pediatr.24(3):323-326.

Abstract

Objective: A neurogenic bladder is one which functions abnormally due to disorders of sacral nerves that control the bladder's ability to fill, store and empty urine. Abnormal bladder function can cause the bladder to be underactive or overactive. This study was planned to evaluate the treatment outcome of our patients with neurogenic bladder dysfunction (NGBD).Methods: Thirty three patients who have been treated for NGBD were evaluated. Diagnosis was confirmed by voiding-cysto-urethrography (VCUG) and urodynamic study. The patients were treated medically and all had clean intermittent catheterization (CIC). Data regarding age, sex, clinical and paraclinical findings, sonography, imagings, renal scan, associated anomalies, treatment and outcomes were collected and entered in SPSS software version18 and analyzed by descriptive statistical.Findings: Totally 33 patients aged three days to four years (mean 6.8 months) were included in this study. There were 20 (61%) males and 13 (39%) females. Mean follow-up period was 3.4±1.2 years (1.5 months to 5 years). Eighty two precent cases had bilatral and 18% unilatral hydronephrosis and bilatral vesicouretral reflux (VUR) existed in 67% and unilatral in 33% of the patients. Treatment consisted of antibiotherapy and CIC in all patients, which was only in 33% of the cases succesful. The most common associated anomaly was meningomyelocle in 8 patients. Vesicostomy was performed in 22 (67%) cases. Kidney scan showed scar in 10 patients at follow-up study. Complete continence on follow-up was achieved in 24 (71% ) patients, and it was improved in 6 (18% ) cases. Mortality rate was 9% (3 cases). Cure rate was 85% in urinary tract infection, 82.7% in hydronephrosis, 80% in VUR and 86.5% in kidney function.Conclusion: Anticholinergic medications was not effective in all our patients. We believe that permanent vesicostomy is an effective and acceptable surgical intervention for protection of upper urinary tract decompression, especially in those who do not respond to medical treatment and have high risk position.

Keywords

Neurogenic Bladder

Treatment Outcome

Urinary Diverssion

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