Vejiga neurogénica no neurogénica (síndrome de Hinman). Dos tratamientos diferentes a un mismo problema

Abstract

Nonneurogenic neurogenic bladder, also known as Hinman syndrome, is a rare entity characterized by nonneurogenic urinary bladder dysfunction. It is a diagnosis of exclusion and is assigned to those children that present with clinical, radiologic, and urodynamic characteristics of a neurogenic bladder with external sphincter dyssynergia, but with no evidence of any neurologic alteration. In 1973, Hinman and Baumann were the first to report a case series of 14 children with nonneurogenic neurogenic bladder and treated these patients with bladder reeducation and hypnosis. Bladder re-training and medical treatment have been recognized as effective management. However, when there is established damage to the upper urinary system, or risk thereof, surgery is preferred over conservative treatment. Due to the low incidence of the disease, there is still no consensus as to the most adequate treatment or management, making it essential to describe every case possible in order to gain the necessary knowledge for providing the best treatment for patients with this syndrome.We present the cases of two boys with Hinman syndrome, 10 and 12 years old, for whom conservative treatment was not sufficient given that they already presented with upper urinary system damage. They underwent successful surgical treatment that was individualized for each case, resulting in 2 different solutions for the same problem.