The urological management of children with spinal cord injury

The urologic management of children with spinal cord injury (SCI) differs from that of the adult insofar as the care involves a developing organ system and will be ongoing for years. Preservation of renal function as well as prevention of urinary tract infection in concert with both bladder and bowel continence are the essential guiding principles.

This is a non-systematic review of the literature and represents expert opinion where data are non-existent. This review focuses on special considerations in children with spinal cord injuries.

SCI in children is less frequent than in adults and affects mainly older children and teenagers. The etiology of SCI in children is usually motor vehicle accidents. The cervical spine is often injured. The urologic evaluation is similar to that for adults but may involve more frequent radiologic and urodynamic assessment to monitor renal function as the child grows.

Treatment may be divided into medical vs. surgical and mirrors the approach to children who have a neurogenic bladder due to spina bifida. Bladder management should be associated with bowel management to achieve the goals of continence and social acceptability.

World journal of urology. 2018 Aug 13 [Epub]

Jairam R Eswara, Miguel Castellan, Ricardo González, Nicolas Mendieta, Marc Cendron

Division of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA. ., Nicklaus Children's Hospital, Joe DiMaggio Children's Hospital, University of Miami, Miami, USA., Jugend-Krankenhaus, Hannover, Germany., Hospital Humberto J. Notti, Mendoza, Argentina., Department of Pediatric Urology, Boston Children's Hospital, Harvard Medical School, Boston, USA.