Voiding dysfunction in children causes, management, and prognosis: A single-center retrospective study

Authors

• Mai Banakhar, From the Department of Pediatrics (El Desoky, Zaher, Kari); from the Paediatric Nephrology Center of Excellence (El Desoky, Kari); from the Department of Urology (Banakhar); and from the Department of Radiology (Khashoggi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
• Khalid Khashoggi, From the Department of Pediatrics (El Desoky, Zaher, Kari); from the Paediatric Nephrology Center of Excellence (El Desoky, Kari); from the Department of Urology (Banakhar); and from the Department of Radiology (Khashoggi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
• Zaher F. Zaher, From the Department of Pediatrics (El Desoky, Zaher, Kari); from the Paediatric Nephrology Center of Excellence (El Desoky, Kari); from the Department of Urology (Banakhar); and from the Department of Radiology (Khashoggi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
• Jameela A. Kari, From the Department of Pediatrics (El Desoky, Zaher, Kari); from the Paediatric Nephrology Center of Excellence (El Desoky, Kari); from the Department of Urology (Banakhar); and from the Department of Radiology (Khashoggi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.

Abstract

Objectives: To review voiding dysfunction caused by 3 different etiologies; dysfunction voiding syndrome (DVS), neurogenic bladder secondary to spinal dysraphisim (NB), and valve bladder syndrome (VBS). Methods: A single-center retrospective study on children with voiding dysfunction followed up at King Abdulaziz University Hospital, Jeddah, Saudi Arabia from 2005 to 2017. Results: One hundred and ninety-nine children (67.3% boys) were included: Group 1 (n=75, DVS), Group 2 (n=64, NB), and Group 3 (n=60, VBS). Further classification according to the age at presentation; infants (46%), toddlers (27%) and school aged (28%). Management categories: 31% children needed observation only, 25% needed clean intermittent catheterization (CIC), 13% needed only surgery and 31% needed both surgery and CIC. Associated comorbidities: hydronephrosis (81%), vesicoureteral reflux (47%), pyelonephritis (37%) and renal scar (60%), all have negative impact on estimated glomerular filtration rate (eGFR). Urodynamic studies revealed poor bladder compliance in 57.6% and atonic bladder in 1.1%, progression to chronic kidney disease (22%), commenced on renal replacement therapy 11.5% and 4% died with ESKD. Overall improvement in the last eGFR is observed ( p <0.001), but VBS group was the least to improve ( p =0.021). There was a negative correlation between the last eGFR and age at presentation (p=0.002). Conclusion: Early diagnosis and management of childhood voiding dysfunction was associated with better prognosis. Children managed conservatively have better preservation of kidney function than those who needed surgery.

Article Type

Research Article

First Page

869

Last Page

877

Recommended Citation

Banakhar, Mai; Khashoggi, Khalid; Zaher, Zaher F.; and Kari, Jameela A. (2021) "Voiding dysfunction in children causes, management, and prognosis: A single-center retrospective study," Saudi Medical Journal: Vol. 42: Iss. 8, Article 9.
DOI: https://doi.org/10.15537/smj.2021.42.8.20210327