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- W2002106661 abstract "No AccessJournal of UrologyPEDIATRIC UROLOGY1 Feb 2003Males With Down’s Syndrome and Nonneurogenic Neurogenic Bladder LIANN N. HANDEL, ALBAHA BARQAWI, GIANCARLO CHECA, PETER D. FURNESS, and MARTIN A. KOYLE LIANN N. HANDELLIANN N. HANDEL More articles by this author , ALBAHA BARQAWIALBAHA BARQAWI More articles by this author , GIANCARLO CHECAGIANCARLO CHECA More articles by this author , PETER D. FURNESSPETER D. FURNESS More articles by this author , and MARTIN A. KOYLEMARTIN A. KOYLE Financial interest and/or other relationship with Bayer and QMed. More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)63983-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We assessed the relationship of trisomy 21 with the most severe dysfunctional elimination syndrome, nonneurogenic neurogenic bladder or the Hinman-Allen syndrome. Materials and Methods: We retrospectively reviewed our experience with children with Down’s syndrome (trisomy 21) in a 10-year period and identified a subset who presented for the evaluation and treatment of urinary tract infections associated with severe disorders of urinary and fecal elimination. Results: Four males 9 months, 14 years, 18 years and 21 years old met the criteria for review. All patients underwent radiological and urodynamic evaluation, and were diagnosed with hydronephrosis and prostatic urethral dilatation with pelvic floor spasticity. Renal function studies showed a creatinine of 0.7 mg./dl. in the 9-month-old, 1.2 mg./dl. in the 14-year-old, 1.9 mg./dl. in the 18-year-old and 2.2 mg./dl. in the 21-year-old patient. Three patients underwent surgical treatment to protect the upper urinary tract, including bladder augmentation cystoplasty and an appendiceal Mitrofanoff stoma in 2, and vesicostomy in 1. The remaining patient was treated conservatively with a behavioral modification program that included timed voiding and a bowel regimen. Conclusions: Boys with trisomy 21 may be at risk for the Hinman-Allen syndrome. Surgical intervention and clean intermittent catheterization for renal preservation and continence can be performed in this population despite intellectual impairment. Further evaluation is necessary to determine whether this relationship is more common than appreciated and whether this syndrome occurs in females with trisomy 21. References 1 : Posterior urethral valves in patients with Down's syndrome. Pediatr Nephrol1996; 10: 143. Google Scholar 2 : Hypospadias and urethral abnormalities in Down's syndrome. Clin Pediatr (Phila)1987; 26: 40. Google Scholar 3 : The malformations of the urinary system in autosomal disorders. Virchows Arch A Pathol Anat Histol1975; 368: 167. Google Scholar 4 : Hirschsprung's disease and urinary tract infection: unrecognized association. 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Google Scholar From the Department of Surgery, Brown University Medical School, Rhode Island Hospital, Providence, Rhode Island, and Division of Urology, Department of Surgery, University of Colorado School of Medicine and Department of Pediatric Urology, Children’s Hospital, Denver, Colorado© 2003 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byPowers M, Brown E, Hogan R, Martin A, Ortenberg J and Roth C (2015) Trends in Toilet Training and Voiding Habits among Children with Down SyndromeJournal of Urology, VOL. 194, NO. 3, (783-787), Online publication date: 1-Sep-2015.MERCER E, BROECKER B, SMITH E, KIRSCH A, SCHERZ H and A. MASSAD C (2018) Urological Manifestations of Down SyndromeJournal of Urology, VOL. 171, NO. 3, (1250-1253), Online publication date: 1-Mar-2004. Volume 169Issue 2February 2003Page: 646-649 Advertisement Copyright & Permissions© 2003 by American Urological Association, Inc.Keywordsabnormalitiesurinary tract infectionsurinary incontinenceDown’s syndromebladderMetricsAuthor Information LIANN N. HANDEL More articles by this author ALBAHA BARQAWI More articles by this author GIANCARLO CHECA More articles by this author PETER D. FURNESS More articles by this author MARTIN A. KOYLE Financial interest and/or other relationship with Bayer and QMed. More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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