Children with Neurogenic Bladder Investigation,Medical Treatment,Radiology

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

Neurogenic Bladder

Clinical Tools

Clinical Vignettes

Diseases & Conditions

Drugs Interaction Calculator

Podcasts

Patient Management Online

Diagnostic Dilemma

Question of the Day

Diagnostic Aid

VACCINE REMINDER

Get the Vaccine Schedule for your child."

Ask Queries

SPECIALIST ANSWERS

Today's Poll

Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?

No, it should be used only after drug sensitivity report

Yes, under guidance of an infectious disease expert

Vote

Results

NEUROGENIC BLADDER

Related Topics

When To Suspect Neurogenic Bladder

Dr. Kumud Mehta.
Consultant Pediatrician & Pediatric Nephrologist.
Jaslok Hospital & Research Centre.
Bai Jerbai Wadia Hospital for children.

Investigations

Urine examination: Routine, microscopy and urine culture for pyuria and bacteriuria to diagnose UTI.

Specific gravity and glucose if polyuria is detected.

Radiology :-
- Plain X-Ray of lumbosacral vertebrae for spina bifida, sacral agenesis
- Ultrasonography to rule out hydronephrosis / hydroureter. Bladder wall thickness, reduced bladder capacity and residual urine are important findings.
- MRI spine in suspected cases to rule out tethering of cord or spinal cord tumors
- MCU to rule out vesicoureteral reflux / obstructive uropathy
Urodynamic studies are useful in accurately identifying the basis of bladder dysfunction. A normal uroflow curve rules out neurogenic bladder dysfunction and indicates normal urine flow rate, peak flow rate, time required to peak flow, volume voided. Evaluation of residual urine bladder capacity, sensation when bladder is full, detrusor contraction and coordination of sphincter relaxation can all be determined by urodynamic studies with EMG of urinary and anal sphincters. Nomograms of uroflowmetric studies appropriate for age, weight and size are used to detect abnormal UDS.

Treatment

A team approach including pediatric surgeon, urologist, pediatrician, nephrologist, radiologist and family is required.

Surgery for meningo or lipomeningomyelocele, obstructive uropathy, hydrocephalus and tethering of spinal cord if detected on MRI is required.

Medical treatment to prevent back pressure and UTI which causes progressive renal damage
- Treatment of urinary tract infection using low dose chemoprophylaxis.
- Bladder training - Periodic voiding, double micturition and bladder retraining using biofeedback techniques.
- Clean intermittent catheterization by the parents who can be taught under supervision to reduce the residual urine and reduce the bladder pressure and ensure complete voiding every three to four hours.
- Drugs like oxybutynin for hyperreflexic bladder and bethanechol etc by pediatric nephrourologist for poor detrusor contraction.

Last created on 08-08-2002
Last updated on 01-07-2007

Mail To Your Friend

Print This Article

Pediatric Nephrology : Expert Views

Expert Views On Hypertension

Expert Views On Hematuria

Expert Views On Renal Failure

Expert Views On Nephrotic syndrome

Pediatric Nephrology : Frequently Asked Question

Renal Failure FAQ'S

VUR FAQ'S

RTA FAQ'S

Nephrotic Syndrome FAQ'S

UTI FAQ'S

TOP SEARCH TERMS

Immunosuppressive therapy for Nephrotic Syndrome

Chronic GN Investigations

Diagnosis of UTI

Hydronephrosis Postnatal evaluation

Hematuria Investigations

High BP in Children

ARF Management

HPLC Technique

Renal Problems Managment

Polyuria approach

Neurogenic bladder management

Clinical Features of VUR

Hemodialysis

RTA Types

Obstructive uropathy Causes

Immunosuppressive Agents

Bartter's syndrome Classification

AKI Pathophysiology

Diseases & Conditions

Pediatric Oncall Journal

Pediatric Conferences

Ped Tools

Adverse Drug Reactions

Head circuferences Calculator

Mid parental height Calculator

Body surface area Calculator

BMR Calculator

Temperature Calculator

Pediatric oncall book store

Partner Sites

Infection in Children

Pedcall

Medical ADRIS

Vaccine Reminder

Pediatric Oncall Journal

Educational Section

Disclaimer:

The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.

Sitemap For Doctor

Sitemap For Parent

Sitemap For Kids