Management of Neuropathic Bladder in Childhood
Management of Neuropathic Bladder in Childhood
复制标题
儿童神经性膀胱的治疗
DOI：
10.1111/j.1469-8749.1984.tb04460.x
复制
发表时间：
1984
影响因子：
3.8
通讯作者：
M. Borzyskowski
中科院分区：
文献类型：
--
作者：
M. Borzyskowski
The causes of defective bladder innervation in childhood include open and closed spina bifida, sacral agenesis, acute myelitis and autonomic neuropathy, spinal-cord compression and trauma. In a few cases, the cause is not known. Affected children present with inefficient bladder-emptying, incontinence, recurrent urinary-tract infections or reflux nephropathy. For some children with only slight neurological handicap the neuropathic bladder is their major handicap, both socially and educationally, and may even be the sole reason for special schooling. An initial assessment of renal function should include measurement of plasma creatinine and glomerular filtration rate and an intravenous urogram. If renal function is imparied, a dimercapto succinic acid (DMSA) scan is required and further tests of divided renal function and urine drainage should be considered. At least three urine specimens should be checked for evidence of infection. It is our practice to investigate by myelography and release a tethered conus or perform other prophylactic surgery around the time of initial assessment, where appropriate. Wherever possible, bladder function should be assessed by means of a videourodynamic study (combined micturating cystourethrogram and cystometrogram). This provides information on: bladder outline, size and capacity; detrusor pressure at rest, during filling and voiding; detrusor activity; the state of the bladder 7 neck and urethra at rest, during filling and during a detrusor contraction; and the presence or absence of vesico-ureteric o(
