Clinical Guideline for the management of Neurogenic Bladder in population under 18 years of age. Part 2: Treatment

Abstract

Neurogenic bladder is a condition with risk of renal damage. The Colombian Association of Pediatric Nephrology (ACONEPE), in collaboration with specialists in pediatric urology, pediatric surgery, pediatric nephrology, and pelvic floor physiotherapists in Latin America, designed a clinical practice guideline for the diagnosis, treatment, and follow-up of patients under 18 years of age with neurogenic bladder.

Objective: To generate guidelines to unify the clinical practice of professionals for the care of patients with neurogenic bladder, in order to reduce associated complications and progression to chronic kidney disease

Material and Method: A systematic search of the literature was carried out. Recommendations of guidelines with a score higher than 60% according to the AGREE II tool were analyzed. Supplementary searches were performed in the case of questions that required additional information. The recommendations were graded according to the GRADE system or according to the original grading. The final recommendations were agreed by expert consensus with an 80% agreement threshold.

Results: The initial search yielded 75 documents, of which 8 clinical practice guidelines published between 2012 and 2020 were included in the initial analysis. Two documents did not meet the domain of methodological rigor, and one did not meet the criteria of editorial independence. In the end, 5 guidelines were included.

Conclusion: Recommendations were generated to unify the clinical practice of healthcare professionals involved in the care of patients with neurogenic bladder. These recommendations are applicable in all Latin American countries. In this second part, recommendations are made regarding the treatment of pediatric patients with neurogenic bladder.