Neurogenic voiding dysfunction in children: challenges of wartime

Abstract

Neurogenic voiding dysfunction (NVD) is the result of the functional inability of the urinary bladder associated with neural dysregulation mechanisms at different levels. During the period when a child grows and thrives, the most important body systems develop. So, the influence of any traumatic events on children has very severe and delayed negative consequences. Post-traumatic stress disorder (PTSD) not only disrupts the psychological state of the child but also provokes a number of pathologies, leading to the progression of already existing problems, especially those associated with a neurovegetative imbalance. Elucidation of the causes and mechanisms of NVD development, which arose against the background of PTSD, gains ground in wartime. NVD in children is often combined with psychobehavioral (attention deficit and hyperactivity disorders, dissociative episodes, increased anxiety, insomnia, night terrors, eating disorders) and somatic (pathology of the digestive, cardiovascular, endocrine systems, infectious diseases, etc.) problems that are exacerbated by PTSD. Close anatomic-functional and neurovegetative interaction of the pelvic organs determines the development of concomitant colonic dysfunction, which very often accompanies NVD. Unfortunately, because of the great variety of clinical manifestations of bladder and bowel dysfunction, the combined pathology is often overlooked, and diagnosed late, which negatively affects the child’s quality of life and psychological state. Attention to the combined dysfunction of the bladder and bowel, timely diagnosis and proper correction with the use of pathogenetic-directed therapy, adequate nutrition, and long-term psycho-rehabilitation measures are necessary measures in the effective management of children in wartime.