The nonneurogenic neurogenic bladder of early infancy

J Urol. 1997 Sep;158(3 Pt 2):1281-5. doi: 10.1097/00005392-199709000-00163.


Purpose: The nonneurogenic neurogenic bladder has traditionally been believed to represent a disorder of older children. We report on patients in whom congenital dysfunctional voiding may be the underlying cause of nonneurogenic neurogenic bladder in early infancy.

Materials and methods: We evaluated 5 male and 2 female patients newborn to 30 months old with dysfunctional neurogenic bladder and no evidence of neurological pathology or anatomical outflow obstruction. Presentation included prenatal hydronephrosis in 3 cases, urosepsis in 2 and failure to thrive in 2. Radiological and urodynamic investigations revealed thick walled, poorly compliant bladders in 5 patients and incomplete bladder emptying bordering on urinary retention in 2. There was significant upper tract pathology in all cases, including azotemia in 4, reflux in 4 and hydroureteronephrosis in 6. Due to poor bladder function, manifested by incomplete emptying or high storage pressures, all patients were initially treated with cutaneous vesicostomy.

Results: Bladder appearance and function subsequently improved in 3 patients and vesicostomy was reversed. Three patients with persistently thickened bladders, including 2 with renal failure, underwent bladder augmentation. The remaining patient had improved bladder storage function but requires intermittent catheterization.

Conclusions: The nonneurogenic neurogenic bladder represents a rare, severe form of dysfunctional voiding that may be present even in the neonatal period.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Urinary Bladder, Neurogenic / etiology*
  • Urinary Bladder, Neurogenic / physiopathology
  • Urination Disorders / complications*
  • Urination Disorders / congenital*