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Neurogenic Bladder Management — RACP Paediatrics MCQ

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ModerateNephrologyNeurogenic Bladder ManagementRACP Paediatrics

A 2-year-old girl has recurrent UTIs despite antibiotic prophylaxis. USS shows bilateral hydronephrosis and a thick-walled bladder. She has a neurogenic bladder secondary to spina bifida. What is the key management to prevent renal damage?

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Correct answer: D — Clean intermittent catheterisation (CIC) and anticholinergic therapy

Neurogenic bladder in spina bifida: CIC (typically 4-6 hourly) and anticholinergic medication (oxybutynin) form the cornerstone of management. CIC ensures regular bladder emptying, reduces UTIs, and protects the upper tracts from high-pressure reflux. Early urological follow-up with urodynamic studies guides management.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Neurogenic Bladder