ESPN 50th Annual Meeting

ESPN 2017


 
What might happen to children with neurogenic bladder dysfunction if their parents neglect nephro-urological follow-up?
Katarzyna Kilis-Pstrusinska 1 Marcin Polok 2 Maciej Baglaj 2

1- Department of Pediatric Nephrology, Wroclaw Medical University, Wroclaw, Poland
2- Department of Pediatric Surgery and Urology, Wroclaw Medical University, Wroclaw, Poland
 
Introduction:

 Myelomeningocele is a congenital defect leading to serious sequels for various organs and systems and therefore medical care with participation of various specialists is necessary.

Aim:  Descriptive clinical study of children whose parents neglected nephro-urological follow-up. This illustrative presentation aims to emphasize the role of pediatric nephrologist and urologist in a long term care of dysraphic patients.

Material and methods:

From the clinical database of myelomeningocele the patients who had ceased their regular follow-up and in whom serious urological complication occurred were identified. Their medical files were analyzed in details including initial urological management and the results of diagnostic imaging and functional studies.

Results:

Seven children (3 girls, 4 boys) with neurogenic bladder dysfunction were included into this study. They had been lost for follow-up review for 4-13 years.  During this period the parents / guardians had not been following the principles of nephrological /urological management. Two of them were re-admitted on emergency basis due to ventriculoperitoneal shunt dysfunction. One girl was admitted to intensive care station with sudden incidence of cardiorespiratory insufficiency in the course of undetected chronic kidney failure. Two children were referred  by a local pediatricians because of significant kidney dilatation detected on USG scan and recurrent urinary tract infection. The last two patients neglected the regular medical care following bladder augmentation. In both of them large bladder calculi were found.  In all but two  patients a marked deterioration of kidney function was noted.  

Conclusions:

All parents / guardians, family doctors and pediatricians should be aware that regular and long term nephro-urological follow up is necessary in children with neurogenic bladder dysfunction, even when urinary symptoms are absent or vague.