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Treatment Outcome of Neurogenic Bladder Dysfunction in Children; A Five-Year Experience

机译:儿童神经源性膀胱功能障碍的治疗结果;五年经验

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>Objective: A neurogenic bladder is one which functions abnormally due to disorders of sacral nerves that control the bladder's ability to fill, store and empty urine. Abnormal bladder function can cause the bladder to be underactive or overactive. This study was planned to evaluate the treatment outcome of our patients with neurogenic bladder dysfunction (NGBD). >Methods: Thirty three patients who have been treated for NGBD were evaluated. Diagnosis was confirmed by voiding-cysto-urethrography (VCUG) and urodynamic study. The patients were treated medically and all had clean intermittent catheterization (CIC). Data regarding age, sex, clinical and paraclinical findings, sonography, imagings, renal scan, associated anomalies, treatment and outcomes were collected and entered in SPSS software version18 and analyzed by descriptive statistical. >Findings >: Totally 33 patients aged three days to four years (mean 6.8 months) were included in this study. There were 20 (61%) males and 13 (39%) females. Mean follow-up period was 3.4±1.2 years (1.5 months to 5 years). Eighty two precent cases had bilatral and 18% unilatral hydronephrosis and bilatral vesicouretral reflux (VUR) existed in 67% and unilatral in 33% of the patients. Treatment consisted of antibiotherapy and CIC in all patients, which was only in 33% of the cases succesful. The most common associated anomaly was meningomyelocle in 8 patients. Vesicostomy was performed in 22 (67%) cases. Kidney scan showed scar in 10 patients at follow-up study. Complete continence on follow-up was achieved in 24 (71% ) patients, and it was improved in 6 (18% ) cases. Mortality rate was 9% (3 cases). Cure rate was 85% in urinary tract infection, 82.7% in hydronephrosis, 80% in VUR and 86.5% in kidney function. >Conclusion: Anticholinergic medications was not effective in all our patients. We believe that permanent vesicostomy is an effective and acceptable surgical intervention for protection of upper urinary tract decompression, especially in those who do not respond to medical treatment and have high risk position.
机译:>目的:一种神经源性膀胱是由于神经失调而异常运作的,disorders神经控制着膀胱的充盈,储存和排空尿液的能力。膀胱功能异常会导致膀胱功能不足或过度活跃。计划进行这项研究以评估我们的神经源性膀胱功能不全(NGBD)患者的治疗结果。 >方法:对33例接受NGBD治疗的患者进行了评估。尿囊膀胱尿道造影(VCUG)和尿动力学检查证实了诊断。所有患者均接受了药物治疗,均接受了清洁的间歇性导管插入术(CIC)。收集有关年龄,性别,临床和副临床表现,超声检查,影像学,肾扫描,相关异常,治疗和结果的数据,并将其输入SPSS软件版本18中,并通过描述性统计进行分析。 >发现 > :该研究共纳入33位三天到四年(平均6.8个月)的患者。男20例(61%),女13例(39%)。平均随访时间为3.4±1。2年(1.5个月至5年)。百分之八十二例患有双侧和18%的单侧肾积水,其中67%的患者存在双侧膀胱尿道反流(VUR),33%的患者存在单侧膀胱尿道反流(VUR)。所有患者的治疗均包括抗生物治疗和CIC,仅成功病例的33%。最常见的相关异常是8例脑膜小球。血管吻合术进行了22例(67%)。在随访研究中,肾脏扫描显示10例患者有疤痕。 24例(71%)患者获得了完全的随访,6例(18%)患者得到了改善。死亡率为9%(3例)。尿路感染的治愈率为85%,肾积水的治愈率为82.7%,VUR的治愈率为80%,肾功能的治愈率为86.5%。 >结论:抗胆碱能药物并非对我们所有患者都有效。我们认为,永久性膀胱造口切开术是保护上尿路减压的有效且可接受的外科手术,特别是在对药物治疗无反应且处于高危位置的患者。

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