Clinical outcomes of non-surgical management of detrusor leak point pressures above 40 cm water in adults with congenital neurogenic bladder

Neurourology and Urodynamics
Giulia I LaneSean P Elliott

Abstract

Neurogenic bladders (NGB) with detrusor leak point pressures >40 cm H2 O (dLPP > 40) have been associated with deterioration of renal function in children with myelomeningocele. For these children, careful pressure management preserves renal function. However, similar evidence is lacking in adult congenital urology (ACU) patients with NGB. We describe renal functional outcomes of non-surgical management of adults with dLPP > 40 or premicturition detrusor pressure (PMDP) >40 cm H2 O, consisting of close follow-up with urodynamic studies (UDS) and renal ultrasound (RUS), paired with adjustments to clean intermittent catheterization (CIC) frequency, anticholinergics, and addition of onabotulinumtoxinA toxin (BTX) injection. We retrospectively reviewed the UDS of all patients at an ACU clinic from 2011 to 2016. Patients with dLPP/PMDP > 40 cm who elected for non-surgical management were included. We describe their management and renal functional outcomes. A total of 33/42 patients with dLPP/PMDP > 40 elected for non-surgical management. 28/33 (85%) were successfully managed without bladder augmentation or urinary diversion at follow-up of nearly 3 years. The median index dLPP/PMDP was 49 cm H2 O (IQR 44, 63) and final dLPP/PMDP was...Continue Reading

References

Feb 1, 1992·The Journal of Urology·R G GerridzenE Dehoux
Dec 1, 1988·The Journal of Urology·S C WangD A Bloom
Aug 1, 1981·The Journal of Urology·E J McGuireR M Weiss
Apr 1, 1994·The Journal of Urology·E J McGuire
May 1, 1996·The Urologic Clinics of North America·E J McGuireH E O'Connell
Apr 1, 2006·Journal of the International Neuropsychological Society : JINS·Maureen DennisJack M Fletcher
May 1, 2009·European Urology·Manfred StöhrerJean-Jacques Wyndaele
May 6, 2009·Annals of Internal Medicine·Andrew S LeveyUNKNOWN CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration)
Jul 21, 2009·The Journal of Urology·Anne P CameronEdward J McGuire
Aug 1, 2009·Physical Medicine and Rehabilitation Clinics of North America·David W Pruitt, Tobias Tsai
Oct 20, 2010·The Urologic Clinics of North America·Edward J McGuire
Feb 18, 2012·The Journal of Urology·Stacy T TanakaJohn W Brock
May 16, 2013·Journal of Intellectual & Developmental Disability·Dinah S ReddihoughElise Davis
Jan 7, 2014·Neurourology and Urodynamics·Andrew GammieUNKNOWN International Continence Society Urodynamic Equipment Working Group
Jul 15, 2015·European Urology·Christopher Woodhouse
Aug 26, 2015·European Urology·Jan GroenBertil Blok
Oct 30, 2016·Annals of the Royal College of Surgeons of England·A R JonesA R Williams
Jul 19, 2017·The Urologic Clinics of North America·Randy A Vince, Adam P Klausner
Jul 19, 2017·The Urologic Clinics of North America·Diana Cardona-Grau, George Chiang
Jul 19, 2017·The Urologic Clinics of North America·Elizabeth V Dray, Anne P Cameron
Jan 1, 2006·Neurourology and Urodynamics·Paul Abrams
Dec 9, 2017·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Guido Filler, Misan Lee

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