Lower urinary tract dysfunction in children with central nervous system tumours
a Department of
Paediatric Neurology, Guy's Hospital, London, UK, b Newcomen Centre, Guy's Hospital
Correspondence to: Dr M Borzyskowski, Consultant Neurodevelopmental Paediatrician, Newcomen Centre, Guy's Hospital, St Thomas Street, London SE1 9RT, UK.
Accepted 24 April 1998
The findings in 10 children with neuropathic vesicourethral
dysfunction after the onset of a central nervous system tumour are
presented. Eight had a spinal tumour and two a brainstem tumour. Bladder dysfunction occurred late in most children except in those with
neoplastic infiltration of the conus and cauda equina. Moreover, tumour
recurrence was often heralded by loss of bladder control before other
neurological signs became obvious. Videourodynamics (VUD) showed
various combinations of "filling" and "voiding" dysfunction in
tumours extending from the pons to the cauda equina, whereas an
isolated "filling" dysfunction was evident in the patient with a
suprapontine tumour. Urinary incontinence and recurrent urine infection
can be immensely distressing to children and their families, particularly when they have had to cope with the stress of diagnosis and treatment of the underlying tumour. Different management
strategies, based on VUD findings, are discussed highlighting the
impact these have on the children's quality of life.
© 1998 by Archives of Disease in Childhood
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