The Changing Urodynamic Pattern in Infants with Myelomeningocele

Roach, Martha; Switters, D. M.; Stone, Anthony R.

doi:10.1016/s0022-5347(17)35657-4

Cited by 31 publications

(6 citation statements)

References 8 publications

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“…We learned from this retrospective study that in addition to voiding cystography, children with myelodysplasia should also undergo a routine cystometrograms to evaluate their urodynamics, as these are directly linked to abnormal bladder control function, in order to assess their susceptibility for developing febrile UTI, even in cases where the children are already undergoing CIC. Due to the fact that the urodynamic pattern in young children with myelodysplasia is an evolving one, 15 periodical re-evaluations are especially important for these patients.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for febrile urinary tract infection in children with myelodysplasia treated by clean intermittent catheterization

Seki¹,

Masuda²,

Kinukawa

et al. 2004

Int J of Urology

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Objective : To identify the factors involved in the incidence of febrile urinary tract infection (UTI) in a retrospective study of children with myelodysplasia who were treated by clean intermittent catheterization.Methods : A total of 76 myelodysplastic children were included in the present study. Any factors, including urodynamic parameters and urinary tract abnormalities, that may have been associated with the incidence of febrile UTI were evaluated using both a univariate analysis and a multiple logistic regression analysis. Results : Of the 76 patients, 19 (25%) had one or more episodes of febrile UTI. A univariate analysis showed low bladder compliance ( < 10 mL/cmH 2 O), detrusor overactivity, bladder trabeculation and the presence of vesico-ureteral reflux (VUR) to be significant factors in the incidence of febrile UTI. The presence of detrusor overactivity and a low bladder compliance, in addition to the presence of VUR, were found to be significant factors for the incidence of febrile UTI using a multivariate analysis.Conclusion : These results demonstrate that, in addition to VUR, urodynamics linked to bladder storage function disorder appear to be directly correlated with the cause of febrile UTI in children with myelodysplasia.

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Section: Discussionmentioning

confidence: 99%

Risk factors for febrile urinary tract infection in children with myelodysplasia treated by clean intermittent catheterization

Seki¹,

Masuda²,

Kinukawa

et al. 2004

Int J of Urology

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“…Urological and neurological complications are the primary causes of morbidity in these patients [2]. Indeed, bladder dysfunction can cause renal damage and urinary incontinence [3]. The early identification and treatment of children at high risk of urinary tract dysfunction are important to preserve renal function and avoid urinary incontinence [4].…”

Section: Introductionmentioning

confidence: 99%

Side‐effects of oral or intravesical oxybutynin chloride in children with spina bifida

et al. 2001

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Objective To evaluate the incidence of side-effects of oral and intravesical oxybutynin chloride in children with meningomyelocele (MMC) and a neurogenic bladder. Patients and methods The study comprised 225 children with a neurogenic bladder from MMC who were evaluated with urodynamic testing and voiding cystourethrography to identify those at high risk of upper tract damage. In all, 101 children (mean age 4.2 years, range 0.25-10) had unco-ordinated detrusor-sphincter function and low compliance; they were treated with either oral or intravesical oxybutynin and clean intermittent catheterization. Results Of the 101 patients, 67 were treated with oral oxybutynin; in 11 the treatment was discontinued because of the side-effects. The other 34 patients used both clean intermittent catheterization and intravesical oxybutynin. In this group there were side-effects in six patients, including drowsiness, hallucinations and cognitive changes. Conclusions Oral and intravesical oxybutynin is effective for managing neurogenic bladder dysfunction, but intravesical administration is safer and better tolerated than oral oxybutynin in the treatment of children with MMC. However, adverse effects such as cognitive impairment can also occur in children treated with intravesical oxybutynin and these patients must be closely monitored because these effects may differ from those with oral administration.

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“…Because urodynamic findings frequently change during longitudinal follow-up, serial urodynamic and upper tract evaluations are recommended every 6 months. 19 Neurologic and urological changes may also occur because of a tethered cord. Fone and colleagues 20 examined the outcome of tethered cord release on preoperative bladder pathologies on 28 patients with MMC and found improved detrusor overactivity or bladder compliance in 30% and worse urodynamic patterns in 48% of the patients.…”

Section: Preservation Of Renal Functionmentioning

confidence: 99%

Management Goals for the Spina Bifida Neurogenic Bladder: A Review from Infancy to Adulthood

Mourtzinos

Stoffel

2010

Urologic Clinics of North America

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The Changing Urodynamic Pattern in Infants with Myelomeningocele

Cited by 31 publications

References 8 publications

Risk factors for febrile urinary tract infection in children with myelodysplasia treated by clean intermittent catheterization

Risk factors for febrile urinary tract infection in children with myelodysplasia treated by clean intermittent catheterization

Side‐effects of oral or intravesical oxybutynin chloride in children with spina bifida

Management Goals for the Spina Bifida Neurogenic Bladder: A Review from Infancy to Adulthood

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