title: Urodynamically controlled management of spinal cord injury in children.
abstract: Spinal cord injuries in children are relatively uncommon. However, infants with cervical spine injury have an especially high risk of renal damage. Six patients, 4 of them tetraplegic, aged 15 months to 8 years, were primarily treated by oral anticholinergic medication and intermittent catheterization. With this concept, satisfactory results were achieved in 4 of 6 children for a mean follow-up of 17.7 months. Mean bladder capacity increased by 128% and intravesical pressure was reduced by 35%. While all patients initially presented with a detrusor leak point pressure above 40 cm H2O, in 4 patients detrusor leak point pressure could be sufficiently reduced by initial treatment. One patient required intravesical instillation of oxybutynin; in another patient sphincterotomy was performed. No patient had signs of renal damage. In summary, even in tetraplegic infants, oral anticholinergic medication and intermittent catheterization is a safe and well-tolerated treatment.
authors.affiliation: Department of Urology, Ruhr-University Bochum, Herne, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Pannek
authors.forename: W
authors.initials: W
authors.lastname: Diederichs
authors.forename: U
authors.initials: U
authors.lastname: Bötel
mesh_terms: D001424:Bacterial Infections / Q000652:urine; D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D014463:Ultrasonography; D001750:Urinary Bladder, Neurogenic / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000628:therapy*; D014556:Urine / Q000382:microbiology; D014563:Urodynamics / Q000187:drug effects; D014718:Vesico-Ureteral Reflux / Q000503:physiopathology