ESPU Congress 2017 - Abstract book

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272 28TH CONGRESS OF THE ESPU
13:09–13:12
S25-6 (PP)
DOES EARLY TREATMENT REALLY IMPROVE PROGNOSIS
IN NEUROPATHIC BLADDER?
Laura BURGOS LUCENA1 , Pedro LÓPEZ PEREIRA2, María José MARTÍNEZ
URRUTIA3, Susana RIVAS VILA3 and Roberto LOBATO ROMERA3
1) Hospital Gregorio Maranon, Paediatric Urology, Madrid, SPAIN - 2) Hospital Universitario La Paz, Urología Pediátrica,
Madrid, SPAIN - 3) Hospital Universitario La Paz, Pediatric Urology, Madrid, SPAIN
BACKGROUND
Clean intermittent catheterisation (CIC) and anticholinergic drugs are the mainstay treatment for
neuropathic bladder (NB). However, there is not consensus about when to start this therapy.
AIM
To analyse the impact of early start of CIC and anticholinergic treatment on long-term renal and
bladder function.
PATIENTS AND METHOD
Retrospective study of NB patients treated in our hospital (1995-2005) dividing them in 2 groups:
group 1 started treatment in the first year of life and group 2 between 1-5 years old. Collected data
included: date of CIC and anticholinergic initiation, presence of VUR or UHN, renal function, UTIs,
renal scars, bladder behaviour and urinary continence.
RESULTS
61 patients were included, 25 (group 1) and 36 (group 2). Initially VUR and overactive bladders were
more frequent in group 2 and during follow-up, one overactive bladder in group 1 and 5 in group
2 changed to low compliance. Therefore, there were 11 low compliant bladders in group 1 and 17 in
group 2 (NS). However, in group 1, only 2 patients required bladder augmentation (BA) compared
to the 12 patients in group 2 (p=0.001). UTIs and new renal scars were more frequent in group
2 (36% vs 12%; 5p vs 1p). At the end of the study mean age was 12.7 and 16.5 years respectively.
CONCLUSIONS
Group 1 had better long-term outcome in terms of UTI, renal scars and surgical procedures and low
compliant bladders required less BA. We strongly recommend starting treatment in the neonatal
period.