Catheterization is sometimes a suitable solution and new research has studied the need for local anesthetic associated with catheterization. A meta-analysis combined many study results and concluded that the effect of local anesthetic was limited.
Sometimes, catheterization is not possible through the urethra and a continent catheterizable channel is surgically created. Different procedures (e.g. Mitrofanoff) can be used and two new studies look into the complications associated with this kind of surgery. Both studies conclude that surgical procedures should only be used in children who cannot perform urethral catheterization, because surgical revisions and long-term complications are common.
Another, maybe more far-fetched, solution to these children's problems is the use of stem cell therapy. A new review summarizes the available evidence for stem cell therapy and show that the use of bone marrow stem cells has potential in bladder tissue regeneration.
https://www.ncbi.nlm.nih.gov/pubmed/28917955
Author and Origin
Chua ME, Firaza PNB, Ming JM, Silangcruz JMA, Braga LH, Lorenzo AJ. Canada
Meta-analysis of 5 studies (369 children) investigating the use of local anesthetic in reducing procedural pain during transurethral bladder catheterization in children.
Local anesthetic using lidocaine gel does not seem to have a significant benefit in decreasing transurethral bladder catheterization pain in children.
Review concluding that local anesthetic gel does not seem to reduce catheter-associated pain in
children.
https://www.ncbi.nlm.nih.gov/pubmed/28864341
Author and Origin
Polm PD, de Kort LMO, de Jong TPVM, Dik P. The Netherlands
Observational retrospective study investigating 112 children who had a continent catheterizable channel
created.
Surgical revision was required in 52 %, with no significant difference observed between techniques.
Study showing that, although a continent catheterizable channel is an effective solution for children who cannot perform urethral catheterization, surgical revisions are common.
http://dx.doi.org/10.1016/j.jpedsurg.2016.09.054
Author and Origin
Faure A, Cooksey R, Bouty A, Woodward A, Hutson J, O’Brien M, Heloury Y. Australia
Observational retrospective study investigating 54 patients who had a continent catheterizable channel created with a Mitrofanoff procedure.
The most common complications were stomal stenosis (50 %), leakage (26 %), conduit stricture
(15%), angulation of the conduit (6 %), and prolapse (3 %). Surgical revision was required in 61 %.
Study showing that, although a continent catheterizable channel is an effective solution for children who cannot perform urethral catheterization, long-term complications are common.
https://www.ncbi.nlm.nih.gov/pubmed/28915233
Author and Origin
Iannaccone PM, Galat V, Bury MI, Ma YC, Sharma AK. US
Review of the use of bone marrow stem cells and induced pluripotent stem cells for bladder regeneration in children with neurogenic bladder.
The use of bone marrow stem cells has demonstrated significant advances in bladder tissue regeneration. The use of induced pluripotent stem cells, however, is still under investigation.
Review summarizing the use of stem cell therapy for bladder regeneration in children with neurogenic bladder.
This blog post is an extract of the Science Alert from Oct 2017 (76040-USX-1710)