The effects of intermittent catheterization and anticholinergic drug in the treatment of children with neurogenic bladder.
- Author:
Soo woong KIM
1
;
Cheol KWAK
;
Kwang Myung KIM
;
Hwang CHOI
Author Information
1. Departmet of Urology, Seoul National University, College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Neurogenic bladder;
Children;
Intermittent Catheterization;
Anticholinergics
- MeSH:
Ataxia;
Catheterization*;
Catheters*;
Child*;
Cholinergic Antagonists;
Humans;
Urinary Bladder;
Urinary Bladder, Neurogenic*;
Urinary Diversion;
Urinary Incontinence;
Urodynamics
- From:Korean Journal of Urology
1993;34(3):512-518
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
From 1985 to 1991, we analyzed experiences in the treatment of 37 children with neurogenic bladder who were closely followed up for averaging 25 months. Initial urodynamic study revealed hyperreflexic bladder in 17 patients: 12 with detrusor sphincter dyssynergia. Areflexic bladder was round in 20 patients: 11 with high leak pressure. Among the 17 patients with hyperreflexic bladder. intermittent catheterization had been well performed in 13 patients and in 11 cages of which oral or topical anticholinergics were added Renal function was well preserved and urinary incontinence was improved in 10 of 13 patients and urinary diversion was done in 1 case. In 4 patients that were not treated by intermittent catheterization owing to poor compliances augmentation cystoplasty was performed or to be considered. Four cases of areflexic bladder with high leak pressure had good results with treatment, whereas 4 cases had deterioration of renal function because of poor complianes to treatment. Among 9 cases of areflexic bladder with low leak pressure, 6 cases were treated by intermittent catheterization. In all of which voidine symptoms were improved. The other 3 cases are under observation without any problems except urinary incontinence. As above, we can conclude that preservation of renal function and improvement of urinary incontinence can be achieved with intermittent catheterization and oral or topical anticholinergics in pediatric neurogenic bladder patients and that noninvasive treatment including Crede maneuver may be used in the treatment of patients with areflexic bladder with low leak pressure.
