Voiding dysfunction in children with acute transverse myelitis

Abstract

Mario Ribeiro*, Sofia Lopes, Ana Ribeiro, Ana Luisa de Carvalho and Raquel Oliveira

Voiding dysfunction is a common and often distressing complication in pediatric patients with Acute Transverse Myelitis (ATM), a rare inflammatory disorder of the spinal cord. This dysfunction, which may present as urinary retention, urgency, or incontinence, results from disruptions in the neural pathways that regulate bladder control. In the acute phase, nearly 95% of children with ATM experience voiding dysfunction, frequently requiring Clean Intermittent Catheterization (CIC). Although the initial management often includes anticholinergic medications and CIC, persistent bladder dysfunction remains prevalent long after the acute phase, with many children continuing to rely on CIC for bladder emptying due to voiding issues. Early intervention, including CIC, plays a critical role in preserving renal function and preventing further complications. Psychological evaluation is also essential, as voiding dysfunction can contribute to emotional and behavioural problems, potentially exacerbating anxiety, depression and social difficulties. Long-term follow-up with pediatric urologists and neurologists is essential for managing urinary health, improving quality of life and enhancing functional recovery.