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Management of neurogenic bladder dysfunction in children update and recommendations on medical treatment.

Authors
  • Sager, Cristian1
  • Barroso, Ubirajara Jr2, 3
  • Bastos, José Murillo Netto4, 5
  • Retamal, Gabriela6
  • Ormaechea, Edurne7
  • 1 Service of Urology, National Hospital of Pediatrics Prof. Dr. P. J. Garrahan, Buenos Aires, Argentina. , (Argentina)
  • 2 Departamento de Urologia, Universidade Federal da Bahia - UFBA, Salvador, BA, Brasil.
  • 3 Escola Bahiana de Medicina (BAHIANA), Salvador, BA, Brasil.
  • 4 Universidade Federal de Juiz de Fora - UFJF, Juiz de Fora, MG, Brasil.
  • 5 Hospital e Maternidade Therezinha de Jesus da Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (HMTJ-SUPREMA), Juiz de Fora, MG, Brasil.
  • 6 Service of Urology, Hospital Roberto del Rio, Santiago, Chile. , (Chile)
  • 7 Service of Urology, Italian Hospital, Buenos Aires, Argentina. , (Argentina)
Type
Published Article
Journal
International braz j urol : official journal of the Brazilian Society of Urology
Publication Date
Jan 01, 2022
Volume
48
Issue
1
Pages
31–51
Identifiers
DOI: 10.1590/S1677-5538.IBJU.2020.0989
PMID: 33861059
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Defective closure of the neural tube affects different systems and generates sequelae, such as neurogenic bladder (NB). Myelomeningocele (MMC) represents the most frequent and most severe cause of NB in children. Damage of the renal parenchyma in children with NB acquired in postnatal stages is preventable given adequate evaluation, follow-up and proactive management. The aim of this document is to update issues on medical management of neurogenic bladder in children. Five Pediatric Urologists joined a group of experts and reviewed all important issues on "Spina Bifida, Neurogenic Bladder in Children" and elaborated a draft of the document. All the members of the group focused on the same system of classification of the levels of evidence (GRADE system) in order to assess the literature and the recommendations. During the year 2020 the panel of experts has met virtually to review, discuss and write a consensus document. The panel addressed recommendations on up to date choice of diagnosis evaluation and therapies. Clean intermittent catheterization (CIC) should be implemented during the first days of life, and antimuscarinic drugs should be indicated upon results of urodynamic studies. When the patient becomes refractory to first-line therapy, receptor-selective pharmacotherapy is available nowadays, which leads to a reduction in reconstructive procedures, such as augmentation cystoplasty. Copyright® by the International Brazilian Journal of Urology.

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