An alternative approach to myelodysplasia management: aggressive observation and prompt intervention.
Publication/Presentation Date
8-1-1994
Abstract
We have adopted an approach to the management of myelodysplasia patients which is contrary to that most commonly supported by the existing literature. We screen patients shortly after birth with ultrasound, urine culture and serum creatinine, and then follow patients at 3 to 6-month intervals with similar studies. Cystography and urodynamics are done only as required clinically or by a change in the sonogram. Clean intermittent catheterization is indicated for continence or medical reasons. With this approach of aggressive observation and prompt intervention, we observed a rate of renal deterioration (diminished function on renal scan or parenchymal loss on imaging studies) of 5%. Renal deterioration was associated statistically with urinary tract infections and reflux. Patients started on clean intermittent catheterization for medical indications had greater risk for renal deterioration than those started on it for continence. Renal deterioration occurred with equal frequency between patients with abnormal and normal urodynamic studies, that is urodynamics did not predict renal deterioration. Our data show a rate of renal deterioration similar to other reports. We believe that aggressive observation with prompt intervention for problems once identified represents a reasonable alternative to managing patients with myelodysplasia.
Volume
152
Issue
2 Pt 2
First Page
807
Last Page
811
ISSN
0022-5347
Published In/Presented At
Teichman, J. M., Scherz, H. C., Kim, K. D., Cho, D. H., Packer, M. G., & Kaplan, G. W. (1994). An alternative approach to myelodysplasia management: aggressive observation and prompt intervention. The Journal of urology, 152(2 Pt 2), 807–811. https://doi.org/10.1016/s0022-5347(17)32716-7
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
8022020
Department(s)
Department of Pediatrics
Document Type
Article