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Urodynamically controlled management of spinal cord injury in children
Author(s) -
Pannek Jürgen,
Diederichs Wolfgang,
Bötel Uwe
Publication year - 1997
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/(sici)1520-6777(1997)16:4<285::aid-nau4>3.0.co;2-a
Subject(s) - medicine , clean intermittent catheterization , anticholinergic , spinal cord injury , anesthesia , oxybutynin , urinary catheterization , surgery , leak , spinal cord , urinary bladder , catheter , overactive bladder , engineering , alternative medicine , pathology , psychiatry , environmental engineering
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. Urodynam. 16:285–292, 1997. © 1997 Wiley‐Liss, Inc.