Abstract：Objective To study the clinical features of vesicoureteral reflux (VUR) in children with neurogenic bladder (NB), and to provide a reference for its early diagnosis and treatment. Methods Clinical data were collected from 26 children with NB and urinary tract infection who were admitted to the Department of Pediatric Nephrology from January 2014 to December 2019. According to the presence or absence of VUR, the children were divided into a VUR group with 11 children and a non-VUR group with 15 children. Clinical features were compared between the two groups. Results Compared with the non-VUR group, the VUR group had a significantly higher proportion of children with non-Escherichia coli urinary tract infection, hydronephrosis (the severity of hydronephrosis increased with the grade of VUR), abnormal 99mTc-DMSA renal scanning findings, elevated ratios of urinary albumin, urinary IgG and urinary transferrin to creatinine, increased residual urine volume, and increased detrusor leak point pressure (P < 0.05). Conclusions When NB children have the clinical manifestations of non-Escherichia coli urinary tract infection, hydronephrosis, abnormal 99mTc-DMSA renal scanning findings, glomerular proteinuria, increased bladder residual urine volume, and high detrusor leak point pressure, such children may already have VUR, and so diagnosis and intervention should be performed as early as possible.
SHEN Meng,PAN Xin-Yue,ZHUANG Jie-Qiu et al. Clinical features of neurogenic bladder with vesicoureteral reflux in children[J]. CJCP, 2021, 23(3): 279-282.
Toprak T, Danacioglu YO, Verit A. The effects of intradetrusor BoNT-A injections on vesicoureteral reflux in children with myelodysplasia[J]. Int Neurourol J, 2019, 23(4):321-326.
[3]
Millner RO, Preece J, Salvator A, et al. Albuminuria in pediatric neurogenic bladder:identifying an earlier marker of renal disease[J]. Urology, 2019, 133:199-203.
Lebowitz RL, Olbing H, Parkkulainen KV, et al. International system of radiographic grading of vesicoureteric reflux. International reflux study in children[J]. Pediatr Radiol, 1985, 15(2):105-109.
[6]
Wang QW, Wen JG, Song DK, et al. Is it possible to use urodynamic variables to predict upper urinary tract dilatation in children with neurogenic bladder-sphincter dysfunction?[J]. BJU Int, 2006, 98(6):1295-1300.
[7]
Zhang F, Liao LM. Sigmoidocolocystoplasty with ureteral reimplantation for treatment of neurogenic bladder[J]. Urology, 2012, 80(2):440-445.
[8]
Friedman S, Reif S, Assia A, et al. Clinical and laboratory characteristics of non-E. coli urinary tract infections[J]. Arch Dis Child, 2006, 91(10):845-846.
[9]
Pauchard JY, Chehade H, Kies CZ, et al. Avoidance of voiding cystourethrography in infants younger than 3 months with Escherichia coli urinary tract infection and normal renal ultrasound[J]. Arch Dis Child, 2017, 102(9):804-808.
[10]
Ortiz TK, Velazquez N, Ding L, et al. Predominant bacteria and patterns of antibiotic susceptibility in urinary tract infection in children with spina bifida[J]. J Pediatr Urol, 2018, 14(5):444.e1-444.e8.
[11]
Timberlake MD, Jacobs MA, Kern AJ, et al. Streamlining risk stratification in infants and young children with spinal dysraphism:vesicoureteral reflux and/or bladder trabeculations outperforms other urodynamic findings for predicting adverse outcomes[J]. J Pediatr Urol, 2018, 14(4):319.e1-319.e7.
[12]
Kari JA, El-Desoky SM, Basnawi F, et al. Vesicoureteric reflux in children[J]. Urol Ann, 2013, 5(4):232-236.
[13]
Fahey FH, Goodkind AB, Plyku D, et al. Dose estimation in pediatric nuclear medicine[J]. Semin Nucl Med, 2017, 47(2):118-125.
[14]
Kovanlikaya A, Kazam J, Dunning A, et al. The role of ultrasonography in predicting vesicoureteral reflux[J]. Urology, 2014, 84(5):1205-1210.
[15]
Bahat H, Ben-Ari M, Ziv-Baran T, et al. Predictors of grade 3-5 vesicoureteral reflux in infants ≤ 2 months of age with pyelonephritis[J]. Pediatr Nephrol, 2019, 34(5):907-915.
[16]
Yavuz S, Anarat A, Bayazıt AK. Interleukin-18, CRP and procalcitonin levels in vesicoureteral reflux and reflux nephropathy[J]. Ren Fail, 2013, 35(10):1319-1322.
[17]
Liu JL, Xu H, Shen Q, et al. Urinary microprotein concentrations in the long-term follow-up of dilating vesicoureteral reflux patients who underwent medical or surgical treatment[J]. Int Urol Nephrol, 2016, 48(1):5-11.
[18]
Prakash R, Puri A, Anand R, et al. Predictors of upper tract damage in pediatric neurogenic bladder[J]. J Pediatr Urol, 2017, 13(5):503.e1-503.e7.
