Urodynamically controlled management of spinal cord injury in children

✍ Scribed by Jürgen Pannek; Wolfgang Diederichs; Uwe Bötel

• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: English
• Weight: 33 KB
• Volume: 16
• Category: Article
• ISSN: 0733-2467
• DOI: 10.1002/(sici)1520-6777(1997)16:4<285::aid-nau4>3.0.co;2-a

✦ Synopsis

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 H 2 O, 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. Neurourol.