Research progress in neurogenic bladder fibrosis in children / 中华实用儿科临床杂志

ABSTRACT

Pediatric neurogenic bladder (PNB) is mostly caused by the dysplasia of lumbosacral spinal cord and nerve, and there is no effective treatment available at present.Bladder fibrosis occurs frequently in PNB, and the prevention and treatment of PNB fibrosis is still a challenge worldwide.Most PNBs develop bladder fibrosis over time, which is characterized by the thickened bladder wall, decreased bladder compliance, and obstruction of the bladder outlet.According to some studies, bladder fibrosis is not only related to bladder smooth muscle cells, but also epithelial cells and mesenchymal cells of bladder.However, the mechanism of fibrosis remains unclear.It has been reported that it is associated with the changes of transforming growth factor-β 1 (TGF-β 1)/ Smad, bladder high pressure and related angiotensin Ⅱ signal pathways.Although anti-fibrotic therapies that target a variety of factors have been employed in animal models, the clinical validation is still needed.It is required to conduct a further exploration on whether early clean intermittent catheterization could prevent the fibrosis in PNB patients with increased residual urine.In this paper, the research progress in PNB fibrosis would be reviewed, in order to provide reference for clinical practice.