Optimal Management of Neurogenic Bladder due to Spinal Cord Injury in Pediatric Patients

Purpose of Review Spinal cord injuries are a well-known cause of neurogenic bladder in children. The aim of this review is to bring the reader up to date on the management of neurogenic bladder in patients with spinal cord injuries. Recent Findings After spinal shock resolution, the most common treatments are anticholinergic medications and intermittent catheterization. Alpha-adrenergic blockers and beta-agonists are the other available medical therapies. Nonetheless, surgery is an alternative when medical treatment alone fails. Slings and urinary sphincters aim to increase bladder outlet resistance, while bladder augmentations increase continence and promote safe storage pressures. Summary Initially, spinal cord injuries cause spinal shock and bladder atony. For this reason, acute management involves adequate bladder emptying with catheterization. Catheterization is essential to protect renal function during the spinal shock phase. Similarly, long-term management also focuses on protecting renal function. However, long-term management should also aim to optimize bladder capacity and pressure, achieve continence, and prevent complications. Several medical and surgical management options are safe and effective for treating neurogenic bladder. Improving the quality of life and considering patient preferences are essential components to treating neurogenic bladder in children.