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Risk factors for febrile urinary tract infection in children with myelodysplasia treated by clean intermittent catheterization
Authors:NARIHITO SEKI  KATSUAKI MASUDA  NAOKO KINUKAWA  KOUHEI SENOH  SEIJI NAITO
Institution:Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. narihito@uro.med.kyushu-u.ac.jp
Abstract:OBJECTIVE: To identify the factors involved in the incidence of febrile urinary tract infection (UTI) in a retrospective study of children with myelodysplasia who were treated by clean intermittent catheterization. METHODS: A total of 76 myelodysplastic children were included in the present study. Any factors, including urodynamic parameters and urinary tract abnormalities, that may have been associated with the incidence of febrile UTI were evaluated using both a univariate analysis and a multiple logistic regression analysis. RESULTS: Of the 76 patients, 19 (25%) had one or more episodes of febrile UTI. A univariate analysis showed low bladder compliance (<10 mL/cmH2O), detrusor overactivity, bladder trabeculation and the presence of vesico-ureteral reflux (VUR) to be significant factors in the incidence of febrile UTI. The presence of detrusor overactivity and a low bladder compliance, in addition to the presence of VUR, were found to be significant factors for the incidence of febrile UTI using a multivariate analysis. CONCLUSION: These results demonstrate that, in addition to VUR, urodynamics linked to bladder storage function disorder appear to be directly correlated with the cause of febrile UTI in children with myelodysplasia.
Keywords:children  clean intermittent catheterization  detrusor-sphincter dyssynergia  myelodysplasia  urinary tract infection
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