Risk Factors for Upper Urinary Tract Deterioration in Children with Neurogenic Bladder.
10.4111/kju.2009.50.12.1248
- Author:
Taekmin KWON
1
;
Junsoo PARK
;
Myung Chan PARK
;
Ji Yeon HAN
;
Kun Suk KIM
Author Information
1. Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. kskim2@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Neurogenic bladder;
Urinary tract;
Risk factors
- MeSH:
Adolescent;
Ataxia;
Child;
Compliance;
Follow-Up Studies;
Humans;
Hydronephrosis;
Intermittent Urethral Catheterization;
Medical Records;
Multivariate Analysis;
Risk Factors;
Spinal Dysraphism;
Urinary Bladder;
Urinary Bladder, Neurogenic;
Urinary Tract;
Urinary Tract Infections;
Urodynamics;
Vesico-Ureteral Reflux
- From:Korean Journal of Urology
2009;50(12):1248-1252
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We evaluated the risk factors for upper urinary tract deterioration in children with neurogenic bladder. MATERIALS AND METHODS: The study population consisted of 60 children (36 boys, 24 girls) with neurogenic bladder confirmed by urodynamic study between January 1994 and June 2007. The average follow-up period was 48 months. The patients' medical records were assessed concerning gender, presence of vesicoureteral reflux (VUR), hydronephrosis, type of spinal dysraphism, level of spinal dysraphism, practice of clean intermittent catheterization (CIC), type of neurogenic bladder, bladder capacity, compliance, detrusor sphincter dyssynergia, recurrent urinary tract infection (UTI), and timing of primary neurosurgical repair. Upper urinary tract deterioration was diagnosed by 99m technetium-dimercaptosuccinic acid renal scan (DMSA) and aggravation of hydronephrosis and VUR. RESULTS: Upper urinary tract deterioration was detected in 15 patients (25%). Hydronephrosis, VUR, and UTI were associated with upper urinary tract deterioration in the univariate analyses. In the multivariate analyses, hydronephrosis [odds ratio (OR)=2.181, 95% confidence interval (CI)=1.191-11.941, p=0.036] and recurrent UTI [OR=5.810, 95% CI=1.200-28.192, p=0.029] were independent risk factors for upper urinary tract deterioration. CONCLUSIONS: Hydronephrosis and recurrent UTI increase the risk of upper urinary tract deterioration in children and adolescents with neurogenic bladder. Therefore, intensive observation and prompt intervention may be recommended for such cases.
