Early treatment improves urodynamic prognosis in neurogenic voiding dysfunction: 20 years of experience,

Abstract Objective: To evaluate the association between early treatment and urodynamic improvement in pediatric and adolescent patients with neurogenic bladder. Methodology: Retrospective longitudinal and observational study (between 1990 and 2013) including patients with neurogenic bladder and myel...

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Main Authors: Lucia M. Costa Monteiro (Author), Glaura O. Cruz (Author), Juliana M. Fontes (Author), Eliane T.R.C. Vieira (Author), Eloá N. Santos (Author), Grace F. Araújo (Author), Eloane G. Ramos (Author)
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Published: Elsevier.
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001 doaj_6bc72841eb0e4fdda78889f00fd1d1ab
042 |a dc 
100 1 0 |a Lucia M. Costa Monteiro  |e author 
700 1 0 |a Glaura O. Cruz  |e author 
700 1 0 |a Juliana M. Fontes  |e author 
700 1 0 |a Eliane T.R.C. Vieira  |e author 
700 1 0 |a Eloá N. Santos  |e author 
700 1 0 |a Grace F. Araújo  |e author 
700 1 0 |a Eloane G. Ramos  |e author 
245 0 0 |a Early treatment improves urodynamic prognosis in neurogenic voiding dysfunction: 20 years of experience, 
260 |b Elsevier. 
500 |a 1678-4782 
500 |a 10.1016/j.jped.2016.11.010 
520 |a Abstract Objective: To evaluate the association between early treatment and urodynamic improvement in pediatric and adolescent patients with neurogenic bladder. Methodology: Retrospective longitudinal and observational study (between 1990 and 2013) including patients with neurogenic bladder and myelomeningocele treated based on urodynamic results. The authors evaluated the urodynamic follow-up (bladder compliance and maximum bladder capacity and pressure) considering the first urodynamic improvement in two years as the outcome variable and early referral as the exposure variable, using a descriptive and multivariate analysis with logistic regression model. Results: Among 230 patients included, 52% had an early referral. The majority were diagnosed as overactive bladder with high bladder pressure (≥40 cm H2O) and low bladder compliance (3 mL/cmH2O) and were treated with oxybutynin and intermittent catheterization. Urodynamic follow-up results showed 68% of improvement at the second urodynamic examination decreasing bladder pressure and increasing bladder capacity and compliance. The percentage of incontinence and urinary tract infections decreased over treatment. Early referral (one-year old or less) increased by 3.5 the probability of urodynamic improvement in two years (95% CI: 1.81-6.77). Conclusion: Treatment onset within the first year of life improves urodynamic prognosis in patients with neurogenic bladder and triplicates the probability of urodynamic improvement in two years. The role of neonatologists and pediatricians in early referral is extremely important. 
546 |a EN 
690 |a Urinary incontinence 
690 |a Neurogenic bladder 
690 |a Urodynamics 
690 |a Treatment 
690 |a Kidney failure 
690 |a Follow-up 
690 |a Pediatrics 
690 |a RJ1-570 
655 7 |a article  |2 local 
786 0 |n Jornal de Pediatria, Vol 93, Iss 4, Pp 420-427 
787 0 |n http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0021-75572017000400420&lng=en&tlng=en 
787 0 |n https://doaj.org/toc/1678-4782 
856 4 1 |u https://doaj.org/article/6bc72841eb0e4fdda78889f00fd1d1ab  |z Connect to this object online.