Urine leakage from the umbilicus in a child with achondroplasia and tetraplegia (due to cervical stenosis): A safety vent for the obstructed neuropathic bladder
Autor: | Subramanian Vaidyanathan, Bakul M Soni, J W H Watt, K R Krishnan |
---|---|
Rok vydání: | 1997 |
Předmět: |
medicine.medical_specialty
Urology medicine.medical_treatment Umbilicus (mollusc) Urinary system Hydronephrosis Urine Quadriplegia Urinary catheterization Achondroplasia Cystography medicine Humans Urinary Bladder Neurogenic Spinal cord injury Tetraplegia Urinary bladder Umbilicus medicine.diagnostic_test Urinary Bladder Fistula business.industry Urinary diversion medicine.disease Surgery Radiography medicine.anatomical_structure Nephrology Child Preschool Female Urinary Catheterization business |
Zdroj: | International Urology and Nephrology. 29:45-51 |
ISSN: | 1573-2584 0301-1623 |
DOI: | 10.1007/bf02551416 |
Popis: | Urine leakage from the umbilicus was observed while expressing urine by the Crede manoeuvre in a three-year-old tetraplegic girl with a chronically distended urinary bladder. Intravenous urography (IVU) revealed bilateral hydroureteronephrosis with markedly distended urinary bladder. Regular three hourly intermittent catheterization was advised, and the parents and carers of this child agreed to perform catheterization. There was cessation of urine leak within 48 hours of urethral drainage. Cystography performed two weeks later showed no vesicoureteric reflux; vesicoumbilical fistula was no longer demonstrable. Follow-up IVU, performed after eight and half months of regular intermittent catheterization, showed regression of hydroureteronephrosis. We believe that urine leakage from the umbilicus served two important protective functions in this child, viz. (1) it prevented possible vesical or renal rupture; (2) the striking clinical symptom of urine leak from the umbilicus focussed the attention of the carers to the underlying serious condition of the urinary tract. Further, this case demonstrates that regression of marked hydroureteronephrosis can be achieved by intermittent catheterization performed at regular intervals by devoted parents/carers, in selected cases of spinal cord injury with neuropathic bladder, and vesical outlet obstruction, thus obviating the need for any form of temporary or permanent urinary diversion. |
Databáze: | OpenAIRE |
Externí odkaz: |