Urinary tract anomalies are sometimes seen in children, and many of them require active treatment to achieve continence. Vesicoureteral reflux and/or a neurogenic bladder secondary to meningomyelocele (e.g. spina bifida) are two examples that require swift action.
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.
Topics: Science Alert, Urinary Tract Infection (UTI), Neurogenic bladder, Catheter-associated UTI (CAUTI)
At the International Continence Society (ICS) meeting in Florence in 2017, there was a round table session dedicated to anal (or fecal) incontinence.
Right from the start in the opening statement, it was established that breaking the silence surrounding fecal incontinence is the most important first step. This is also the main conclusion of a recently published review, which covers clinical management of fecal incontinence from the gynecologist’s perspective: Medical professionals should always ask the patient about anal and fecal incontinence.
Topics: Science Alert, Bowel management
Urinary tract infections (UTIs) are a heavy burden on the healthcare system today. UTIs are also one of the most common complications among people living with a neurogenic bladder, causing significant complications and health hazards. New clinical research investigates the clinical problem and demonstrates that UTIs are still among the leading causes of death in people with a neurogenic bladder.
On average, people with a neurogenic bladder experience 2 UTI events every year, requiring repeated antibiotic treatments. Frequent use of antibiotics is one of the main contributors to the high prevalence of antibiotic-resistant bacteria today, and as a result, UTIs are getting more expensive and more difficult to treat. As a consequence, there is a major focus in clinical research on the search for non-antibiotic prophylactic treatment for UTIs.
Topics: Science Alert, Urinary Tract Infection (UTI), Neurogenic bladder, Catheter-associated UTI (CAUTI)
There are many conservative options and combinations of methods when it comes to bowel management for people with neurogenic bowel disorder (NBD).
Usually they involve diet, exercise, laxatives, as well as other methods. For some people who have struggled with conservative bowel management, surgery has been the only alternative, but surgery is generally best avoided as there may be a number of complications associated with it.
Topics: Science Alert, Bowel management, Transanal irrigation (TAI)
At a first glance, assisted urine voiding through catheterization may seem like an unnatural thing. If, however, the evidence surrounding intermittent catheterization (a more technical name for it) is studied, it becomes clear that this is indeed something useful. New research reveals that intermittent catheterization is a central part of many treatment regimens. In this month’s Science Alert we look into some of them.
Three newly published studies highlight the use of intermittent catheterization in children. The therapy is identified as a central treatment option for urological management of children with spina bifida, but it is also recognized as a suitable and central option in resource-poor settings. In another, more resource-strong setting, evidence in favor of hydrophilic-coated catheters for intermittent use has been found. The evidence suggests that hydrophilic-coated catheters decrease the risk of urinary tract infection (UTI), as compared to non-coated catheters, when used for intermittent catheterization in children with neurogenic bladder.
Topics: Science Alert, Urinary Tract Infection (UTI), Catheter-associated UTI (CAUTI)
