EFFICIENCY OF DETRUSOR CHEMODENERVATION WITH BOTULINUM TOXIN IN COMBINATION WITH CONSERVATIVE THERAPY IN A CHILD WITH NEUROGENIC BLADDER AND MYELODYSPLASIA: A CLINICAL CASE

Q4 Medicine Pediatriya - Zhurnal im G.N. Speranskogo Pub Date : 2023-08-10 DOI:10.24110/0031-403x-2023-102-4-193-197

M. A. Romashin, N. B. Guseva, E. Mlynchik, S. S. Nikitin

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Abstract

Dysfunction of the pelvic organs in children with myelodysplasia is a complex multifaceted problem. In some patients with long-term vesicoureteral reflux, as a complication of neurogenic bladder dysfunction, reflux nephropathy (RN) develops in a chronic kidney disease (CKD) outcome. One of the most effective as well as minimally invasive surgical interventions in this case is chemodenervation of the detrusor with botulinum toxin. This intervention in most cases not only improves the quality of life of patients, but also prevents further development of RN helping children to avoid traumatic augmentation surgery in the future. However, the duration of the chemodenervation effect is often insufficient. In the Authors’ opinion, synergistic conservative therapy aimed at improving regional blood circulation and correcting energy deficit is a must in order to improve the results. The result of the synergy of surgical and conservative treatment and their effectiveness are described in the presented clinical case observation.

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肉毒毒素联合保守治疗逼尿肌化学神经切断术治疗神经源性膀胱和骨髓发育不良1例临床观察

骨髓发育不良儿童盆腔器官功能障碍是一个复杂的多方面问题。在一些长期膀胱输尿管反流患者中，作为神经源性膀胱功能障碍的并发症，反流肾病(RN)发展为慢性肾病(CKD)结局。在这种情况下，最有效的微创手术干预之一是用肉毒杆菌毒素对逼尿肌进行化学神经切断。在大多数情况下，这种干预不仅提高了患者的生活质量，而且还阻止了RN的进一步发展，帮助儿童避免未来的创伤性隆胸手术。然而，化学神经支配作用的持续时间往往不足。笔者认为，为了改善疗效，必须采取以改善局部血液循环和纠正能量亏缺为目的的协同保守治疗。手术和保守治疗协同作用的结果及其效果在本文的临床病例观察中被描述。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatriya - Zhurnal im G.N. Speranskogo Medicine-Pediatrics, Perinatology and Child Health

CiteScore

0.60

自引率

0.00%

发文量

150

期刊介绍： Journal “Pediatria” named after G.N. Speransky (the official short names of the Journal are “Journal «Pediatria»,” “Pediatria,” and “«Pediatria,» the Journal”) is the oldest Soviet-and-Russian (in the Russian Federation, the CIS and former Soviet Union) scientific and practical medical periodical assigned for pediatricians that is published continuously since May, 1922, and distributed worldwide. Our mission statement specifies that we aim to the ‘raising the level of skills and education of pediatricians, organizers of children’s health protection services, medicine scientists, lecturers and students of medical institutes for higher education, universities and colleges worldwide with an emphasis on Russian-speaking audience and specific, topical problems of children’s healthcare in Russia, the CIS, Baltic States and former Soviet Union Countries and their determination with the use of the World’s best practices in pediatrics.’ As part of this objective, the Editorial of the Journal «Pediatria» named after G.N. Speransky itself adopts a neutral position on issues treated within the Journal. The Journal serves to further academic discussions of topics, irrespective of their nature - whether religious, racial-, gender-based, environmental, ethical, political or other potentially or topically contentious subjects. The Journal is registered with the ISSN, - the international identifier for serials and other continuing resources, in the electronic and print world: ISSN 0031-403X (Print), and ISSN 1990-2182 (Online). The Journal was founded by the Academician, Dr. Georgiy Nestorovich SPERANSKY, in May, 1922. Now (since 1973) the Journal bears his honorary name.