Clinical Course of Pediatric Patients with Neurogenic Bladder in Yemen

Background: Neurogenic bladder in children is a major cause of progressive upper urinary tract deterioration and chronic kidney disease if not diagnosed and managed early. High intravesical pressure, recurrent urinary tract infections, and vesicoureteral reflux are key contributors to renal damage, particularly in resource-limited settings. This study aims to evaluate the clinical course of pediatric patients with neurogenic bladder in Sana’a city, Yemen. Patients and Methods: This multicentric cross-sectional descriptive study was conducted between January and December 2024 across multiple hospitals and specialized clinics in Sana’a city. Children aged 2–15 years with confirmed neurogenic bladder were included. Data collected comprised demographic characteristics, etiology, neurological and lower urinary tract manifestations, management strategies, history of urinary tract infections, renal function parameters, and imaging findings. Renal function was assessed using serum creatinine and estimated glomerular filtration rate, while radiological evaluation was based on ultrasound. Results: A total of 54 children were included, with a mean age of 8.60 ± 3.18 years; 53.7% were females. Myelomeningocele was the most common etiology (57.4%). All patients presented with lower urinary tract symptoms and recurrent urinary tract infections. Hydronephrosis was present in all patients, and vesicoureteral reflux was detected in 92.6%, predominantly bilateral. Renal impairment was universal, with 90% of patients diagnosed with chronic kidney disease and 5.6% requiring regular dialysis. Clean intermittent catheterization was underutilized, while indwelling catheterization and vesicostomy were frequently employed. Conclusion: Pediatric neurogenic bladder in Yemen is associated with a high burden of renal morbidity, largely due to delayed diagnosis and suboptimal early bladder management. Early detection, timely initiation of clean intermittent catheterization, and structured multidisciplinary follow-up are essential to preserve renal function and prevent progression to chronic kidney disease.