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29
th
CONGRESS OF THE ESPU
S21: NEUROPATHIC BLADDER
Moderators: Anju Goyal (UK), Erik Van Laecke (Belgium)
ESPU Meeting on Saturday 14, April 2018, 08:10–09:10
08:10–08:13
S21-1 (PP)
DOES THE INTRODUCTION OF CLEAN INTERMITTENT
CATHETERIZATION AND ANTIMUSCARINIC THERAPY
IN THE NEWBORN PERIOD PRESERVE RENAL FUNCTION
IN CHILDREN WITH SPINA BIFIDA?
Annarita MARINO
1
, Salvatore CASCIO
1
, Orla MCMAHON
1
, Emer ALDRIDGE
1
and
Malcolm LEWIS
2
1) Children's University Hospital, Department of paediatric surgery and urology, Dublin, IRELAND -
2) Children's University Hospital, Department of paediatric nephrology, Dublin, IRELAND
PURPOSE
It is still a matter of debate among paediatric urologists when clean intermittent catheterization (CIC)
and antimuscarinic therapy should be introduced in children with spina bifida. The aim of this study
was to assess if late introduction of CIC was associated with a higher incidence of renal damage.
MATERIAL AND METHODS
We reviewed data on all patients with open myelomeningocele who attended the Spina Bifida Clinic.
In group 1 patients were started on CIC and antimuscarinic therapy after birth and in group 2 CIC
was introduced after their first birthday. Renal damage was assessed using DMSA scan and eGFR
calculated with the Schwartz formula.
RESULTS
104 patients were identified, 39 in group 1 and 65 in group 2. The mean age at the introduction of
CIC was 0 in group 1 and 42 months in group 2. All children in group 1 had a normal eGFR while
2(3 %) had abnormal eGFR in group 2 (p=ns). DMSA scan showed renal damage in 3(6 %) of those
in group 1 compared with 13 (20 %) of group 2 (p=ns). There was no difference in the incidence of
unilateral or bilateral VUR (20 % group 1, 12 % group 2).
CONCLUSIONS
Whilst there was more renal damage on DMSA in group 2, there was less reflux on cystography in
this group. These differences did not reach statistical significance. We have not been able to show
that the current practice of early institution of CIC and antimuscarinic therapy has a renal protective
effect in our cohort of patients.