The influence of bladder compliance on children with neurogenic underactive bladder treated with clean intermittent self-catheterization

Abstract

Objective To investigate the influence of bladder compliance on complications and bladder development on children with neurogenic underactive bladder (NUB) treated with clean intermittent self-catheterisation (CISC). Methods In this study, 109 school children with NUB were enrolled. Of all the patients,93(85%) were successfully followed up for two years after CISC. According to bladder compliance,93 patients were further subdivided into two groups, normal bladder compliance group (49 patients including 30 boys and 19 girls with the mean age of 6. 3± 0.9 years,as the NBC group) and poor bladder compliance group (44 patients including 29 boys and 15 girls with the mean age of 7. 0± 1.0 years,as the PBC group). Urodynamic parameters and complications were compared between two groups. Results After CISC for two years, the maximal cystometric capacity (MCC) and relative safe cystometric capacity (RSCC) in the NBC group were respectively significantly higher than those before CISC. However, the RSCC in the PBC group was significantly lower than that before CISC,and detrusor leakage point pressure (DLPP) was significantly higher than that before CISC (P <0. 05). Moreover, the bladder compliance, MCC and RSCC in the PBC group were respectively significantly lower than those in the NBC group after CISC,and DLPP was significantly higher than that in the NBC group (P<0. 05). The incidence of baeteriuria,vesico ureteral reflux (VUR), febrile urinary tract infections (FUTI) and macroscopic hematuria were respectively 33. 3%, 12. 9%,24. 7% and 15. 1%. VUR and FUTI in the PBC group were significantly higher than those in the NBC group (P< 0. 05). Conclusions It is suggested that bladder compliance may influence the bladder development and complications in children with NUB treated with CISC. Close monitoring and follow-up are necessary for the patients with poor bladder compliance and progressive deteriorated bladder development. Key words: Bladder neurogenic; Urodynamics; Bladder compliance