children s health issues
Bladder Defects
 Problems with nerves to the bladder ( Neurogenic Bladder )
Birth defects that affect the nerves to the bladder, particularly spinal cord defects such as Spina Bifida , cause problems in several ways: Flaccid bladder: The nerve problem makes the bladder muscles limp and weak (flaccid). The bladder cannot contract properly to empty itself, so urine tends to fill up the bladder at low pressure. Spastic bladder: The nerve problems cause the bladder to contract too much (spastic), and urine in the bladder is at high pressure. The bladder is small. In some children, the bladder is sometimes flaccid and at other times spastic. If children cannot empty their bladder completely, urine can become stagnant, which increases the risk of Urinary Tract Infection (UTI) in Children (UTIs) or formation of If catheterization does not work, a surgical procedure called a vesicostomy may be done. In this procedure, doctors make an opening between the abdominal wall and the bladder. Urine drains from the bladder through the opening into a diaper. An alternative to vesicostomy is to create a channel or tunnel between the bladder and the skin. A catheter can be placed in this channel. If the urine is under high pressure, the urine may flow backward from the bladder into the kidneys ( Urinary Reflux ). Urinary reflux may cause recurring urinary tract infections, kidney damage, or both. Children who have a small bladder and increased bladder pressure may be given drugs to relax the bladder muscles or may be catheterized. If these measures do not work, doctors may do surgery to help decrease the involuntary release of urine and decrease bladder pressure so the kidneys do not become damaged. Some surgical procedures increase the size of the bladder. However, after surgery, children usually still need catheterization. 