ABSTRACT
El objetivo de esta guía es servir de instrumento para un mejor seguimiento y tratamiento del reflujo vesicoureteral (RVU) primario ya diagnosticado, mediante una serie de recomendaciones, acerca del manejo del mismo, en el ámbito de pediatría de atención primaria, servicios de pediatría general, unidades de nefrología pediátrica, servicios de cirugía pediátrica y servicios de urología con actividad en la edad pediátrica. Otro objetivo es conseguir una adecuada información a los padres y cuidadores a la hora de plantear el tratamiento y seguimiento del RVU primario o esencial.
Subject(s)
Humans , Vesico-Ureteral Reflux/surgery , Vesico-Ureteral Reflux/diagnosis , Vesico-Ureteral Reflux/rehabilitation , Critical PathwaysABSTRACT
The Infrequent Voider Syndrome or Lazy Bladder Syndrome in children is characterized by a large capacity bladder, frequently associated with a significant volume of residual urine. Usually these patients arrive at medical examination with a history of recurrent urinary infections but without anomalies in the upper urinary tract. We report about a young girl affected by one-sided 20 degree vesico-ureteral reflux due to Lazy Bladder Syndrome that had never been diagnosed before. This patient has been submitted to a prompt bladder training and seems presently to have at last gained a physiological micturition after 9 months of follow-up,without actual evidence of vesico-ureteral reflux. Therefore we must stress that it is prominently important considering every notice about infrequent micturition in a paediatric case history or a large capacity bladder, noticed by chance too. These reports may be fundamental for early diagnosis of Lazy Bladder Syndrome.
Subject(s)
Urinary Bladder Diseases/complications , Vesico-Ureteral Reflux/etiology , Algorithms , Anti-Infective Agents, Urinary/therapeutic use , Child, Preschool , Female , Humans , Syndrome , Treatment Outcome , Trimethoprim/therapeutic use , Urinary Bladder Diseases/diagnosis , Urinary Bladder Diseases/drug therapy , Urinary Bladder Diseases/rehabilitation , Urinary Tract Infections/complications , Urinary Tract Infections/prevention & control , Vesico-Ureteral Reflux/diagnosis , Vesico-Ureteral Reflux/drug therapy , Vesico-Ureteral Reflux/rehabilitationABSTRACT
Intermittent catheterization (ICP) is a well-proven effective means of urologic management for spinal cord diseased (SCD) persons who meet the following criteria: adequate low pressure bladder capacity (350-400 cc minimum), adequate hand function, unobstructed urethra and compliant, understanding, continent, cooperative patients. Time-directed (Q4 H-Q6 H), ICP-obtained volumes on twenty-one patients revealed a majority of early, unnecessary as well as some late over-distended bladder catheterizations. The PCI 5000 or "Bladder Manager", a miniaturized ultrasonic bladder volume measuring device developed by Diagnostic Ultrasound of Seattle, was evaluated. It allowed the patients to perform volume-directed ICP which results in less frequent catheterizations and prevents bladder overdistension.
