NEUROGENIC BLADDER DYSFUNCTION IN CHILDREN PROGRESS TO KIDNEY FAILURE IN ADOLESCENCE AND YOUNG AGE: PERSONALISED MENAGEMENT, REVIEW AND CASE SERIES

Newborn infants who had neurogenic bladder dysfunction (NBD) have a normal upper urinary tract.
Most of them will develop deterioration of renal function, and chronic kidney disease in case they do
not received proper management. Renal damage is due to high detrusor pressures resulted from poor
compliance of the bladder, beside detrusor over-activity against a closed sphincter or detrusor sphincter
dyssynergia.
To preserve renal function and prevent deterioration of the kidneys, NBD must be treated immediately
after being diagnosed. Over the last few years there was great progress in the treatment of children
with the NBD. Neurogenic bladder dysfunction in children must be diagnosed early in life and the
child should receive the proper management, neglecting the case or improper management would end
with deleterious effect on the upper tract end with renal dysfunction and chronic kidney failure. There
are different options for management. The type of management would be personalized for each case
and could be modified. Case series were presented to illuminate the early management value of children
with NBD in situation of unavailable of advanced methods of treatment.
The different approaches for management including the recent approaches were reviewed. This case
series elaborate the management of 24 Egyptian children with NBD and impairment of renal function.
The children underwent cutaneous vesicostomy at early stages of the disease. The procedure was feasible
and protected the kidney from deterioration tell adolescence. This procedure is feasible in limited
hospital resources and/or low-middle income countries.