2023 Canadian Urological Association/Pediatric Urologists of Canada guideline: Pediatric patients with neurogenic lower urinary tract dysfunction Full-text version
Abstract
INTRODUCTION AND BACKGROUND Neurogenic lower urinary tract dysfunction (NLUTD) refers to abnormal function of the bladder, bladder neck, and/or sphincters associated with any neurologic disorder.1 Congenital pediatric NLUTD is mainly caused by spinal dysraphism, commonly spina bifida (SB).2 Pediatric NLUTD is increasingly prevalent in Canada. A populationbased study conducted in Canada (excluding Quebec) from 2004–2015 showed that there were 4.4 cases of neural tube defects (NTDs) per 10 000 total births; however, the prevalence of NTDs increased from 3.6 in 2004 to 4.6 per 10 000 in 2015. Specifically, SB was the only NTD subtype with an increasing prevalence over time.3,4 Pediatric patients with NLUTD are at risk for recurrent urinary tract infections (UTI) and upper tract damage leading to chronic kidney disease, necessitating early detection and management.2 In addition, advances in prenatal diagnosis of congenital spinal dysraphism in Canada enable early detection and prenatal intervention.5,6 Managing the resultant pediatric NLUTD requires collaboration among various healthcare providers to ensure healthy long-term outcomes.
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