Neurogenic Bladder
Everything in the library about neurogenic bladder — built automatically from the recorded discussions that name it
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Medical Management
1 item
Neurogenic Bladder
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This podcast is an interactive discussion about Neurogenic Bladder between Dr. Rae Hanke, Dr. Lynn Woo, and Dr. Al Ray Dr. Lynn Woo is an Associate Professor of Urology and Program Director at Case Western and Cleveland Medical Center. She
podcast55:25 · Dec 2020
Complications
1 item
Cloaca - Urologic Concerns
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Dr. Brian A. VanderBrink,Urologist and an Assistant Professor atUC Department of Pediatrics,presents on Urology risk Stratification. Dr. VanderBrink'sdiscussion includes topics onrisk factors for Urologic dysfunction such as UTI risk as wel
video25:29 · Nov 2018
Evidence & Research
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Association Between Social Determinants of Health and Choice of Urinary Reconstruction in Children
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Dr. Megan Read Ivaturi from Nationwide Children's Hospital discusses a study on how social determinants of health influence the choice of urinary reconstruction in children. The research, a single-institution retrospective study of 208 pati
video1:22 · Jun 2026
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Every expert statement below comes from the recorded discussions, with its speaker and moment.
Association Between Social Determinants of Health and Choice of Urinary Reconstruction in Children
The study was a single institution retrospective study of 208 patients with neurogenic bladder, anorectal malformations, myelomeningocele, and other spinal cord pathology who underwent urinary reconstruction between 2014 and 2021
epidemiologicalMegan Reedy Vituri0:11 ↗
About 74% of patients underwent continent reconstruction and 26% underwent incontinent reconstruction
epidemiologicalMegan Reedy Vituri0:32 ↗
There was no difference in reconstruction type based on insurance type
epidemiologicalMegan Reedy Vituri0:38 ↗
There was no difference in reconstruction type based on childhood opportunity index
epidemiologicalMegan Reedy Vituri0:38 ↗
Patients who had incontinent reconstruction were more likely to have food insecurity
epidemiologicalMegan Reedy Vituri0:38 ↗
Patients who had incontinent reconstruction were more likely to have missed appointments
epidemiologicalMegan Reedy Vituri0:38 ↗
Patients who had incontinent reconstruction were more likely to have unmarried parents
epidemiologicalMegan Reedy Vituri0:38 ↗
Patients who traveled from out of state were more likely to have a continent diversion
epidemiologicalMegan Reedy Vituri0:49 ↗
Social stability and the ability to engage with follow-up may be influencing what surgeons offer families as well as what families can realistically manage
opinionMegan Reedy Vituri0:57 ↗
The best reconstruction isn't just one that's technically feasible, it also needs to be sustainable for patients and their families
opinionMegan Reedy Vituri1:08 ↗
Cloaca - Urologic Concerns
In Dr. Pena's series of 193 cloaca patients old enough to assess continence with common channel <3 cm, almost one-third were on intermittent catheterization for infections, radiographic findings, or incontinence.
host_summary0:00 ↗
In cloaca patients with common channel >3 cm, the rate of intermittent catheterization was much higher than in those with <3 cm channels.
host_summary0:00 ↗
In a study of anorectal malformations, up to 40% of patients with abnormal spinal cord had urodynamic evidence of bladder abnormalities, higher than those with normal spinal cord.
host_summary0:00 ↗
In children with solitary kidneys and CAKUT (congenital anomalies of kidney and urinary tract), 50% had chronic kidney disease and were on antihypertensive medication by age 9, compared to 33% in those without CAKUT.
host_summary0:00 ↗
Preoperative and postoperative urodynamic studies in cloaca patients with common channel <2 cm repaired via posterior sagittal approach have not demonstrated very deleterious effects.
clinical0:00 ↗
Cloacas are the highest-risk patients among anorectal malformation patients for bladder dysfunction.
opinion0:00 ↗
Long-term renal outcomes in cloaca patients show 44-75% develop chronic kidney disease across multiple centers (Great Ormond Street, Riley Hospital, Sick Kids).
host_summary0:00 ↗
End-stage renal disease occurs in 10-15% of cloaca patients, much higher than the general population.
host_summary0:00 ↗
In the speaker's institutional cohort of cloaca patients (mean age 4.5 years), almost half had CKD stage 2 or 3 (GFR 30-90 mL/min).
epidemiological0:00 ↗
In a study of 44 cloaca patients at the speaker's institution (mean common channel 4 cm, high percentage with neurogenic bladder on active management), none showed CKD stage progression over mean 5-year follow-up.
epidemiological0:00 ↗
Vesicostomy is not the speaker's first choice for bladder drainage; preference is to keep bladder closed rather than create vesicostomy where capacity and management can be more difficult.
opinion17:14 ↗
Vesicostomy may be indicated in cases with solitary renal unit, massively dilated renal unit or hydroureter, or intraoperative concerns about urethral viability for catheterization or voiding.
clinical17:14 ↗
For cloaca patients with common channel 2 cm, normal sacrum, no tethered cord, and uncomplicated repair, Dr. Pena leaves only a Foley catheter (not suprapubic) for 2-3 weeks, expecting the patient will void spontaneously after removal.
clinicalPena18:58 ↗
For more complicated cloaca cases (common channel ≥3 cm, tethered cord, abnormal sacrum), Dr. Pena uses suprapubic tube to enable urodynamic studies and avoid nighttime voiding emergencies.
clinicalPena18:58 ↗
For patients with very poor bladder, mega-ureter, single kidney, hydronephrosis, and reflux, Dr. Pena considers vesicostomy necessary.
clinicalPena18:58 ↗
Patients born with single kidney and hydronephrosis are very high risk and most likely will end up with kidney transplant.
host_summary20:23 ↗
Database review at Cincinnati Children's identified high-risk group for kidney transplant: patients with kidney failure at birth, ectopic ureters, cloaca, and strictured common channel.
epidemiologicalAndrea20:51 ↗
Mitrofanoff is not performed at time of primary cloaca repair; it is done at older age when fecal incontinence and bowel management needs are clearer (toilet-training age).
clinical21:54 ↗
When both Mitrofanoff and Malone are needed, the appendix can potentially be divided if vascular anatomy and length permit, allowing use for both procedures.
clinical21:54 ↗
Some U.S. centers place Malone antegrade continence enema at time of colostomy closure, but the speaker's institution waits to assess laxative response first, as Dr. Pena has seen successful laxative management in cases where he had zero confidence.
clinical21:54 ↗
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