Korean J Urol.  2009 Dec;50(12):1248-1252.

Risk Factors for Upper Urinary Tract Deterioration in Children with Neurogenic Bladder

• Kwon T
• Park J
• Park MC
• Han JY
• Kim KS

Abstract

PURPOSE
We evaluated the risk factors for upper urinary tract deterioration in children with neurogenic bladder.
MATERIALS AND METHODS
The study population consisted of 60 children (36 boys, 24 girls) with neurogenic bladder confirmed by urodynamic study between January 1994 and June 2007. The average follow-up period was 48 months. The patients' medical records were assessed concerning gender, presence of vesicoureteral reflux (VUR), hydronephrosis, type of spinal dysraphism, level of spinal dysraphism, practice of clean intermittent catheterization (CIC), type of neurogenic bladder, bladder capacity, compliance, detrusor sphincter dyssynergia, recurrent urinary tract infection (UTI), and timing of primary neurosurgical repair. Upper urinary tract deterioration was diagnosed by 99m technetium-dimercaptosuccinic acid renal scan (DMSA) and aggravation of hydronephrosis and VUR.
RESULTS
Upper urinary tract deterioration was detected in 15 patients (25%). Hydronephrosis, VUR, and UTI were associated with upper urinary tract deterioration in the univariate analyses. In the multivariate analyses, hydronephrosis [odds ratio (OR)=2.181, 95% confidence interval (CI)=1.191-11.941, p=0.036] and recurrent UTI [OR=5.810, 95% CI=1.200-28.192, p=0.029] were independent risk factors for upper urinary tract deterioration.
CONCLUSIONS
Hydronephrosis and recurrent UTI increase the risk of upper urinary tract deterioration in children and adolescents with neurogenic bladder. Therefore, intensive observation and prompt intervention may be recommended for such cases.

Keyword

Neurogenic bladder; Urinary tract; Risk factors

MeSH Terms

Adolescent
Ataxia
Child
Compliance
Follow-Up Studies
Humans
Hydronephrosis
Intermittent Urethral Catheterization
Medical Records
Multivariate Analysis
Risk Factors
Spinal Dysraphism
Urinary Bladder
Urinary Bladder, Neurogenic
Urinary Tract
Urinary Tract Infections
Urodynamics
Vesico-Ureteral Reflux

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