Effectiveness of Rehabilitation Intervention on Overactive Bladder After Spinal Aneurysmal Bone Cyst Surgery in A Child: A Case Report

Managing overactive bladder (OAB) in children is recommended to involve rehabilitation intervention including urotherapy, clean intermittent catheterization (CIC), and medication. However, there is scarce evidence on the management of OAB in children in Vietnam, as well as the effectiveness of combining urotherapy, CIC, and medication in managing this condition. We report a case of an 11-year-old female pediatric patient with OAB following aneurysmal bone cyst (ABC) surgery. She was diagnosed with a T8 vertebral ABC at the age of seven years and underwent curative surgery with spinal fusion. Postoperatively, she was diagnosed with neurogenic bladder and was prescribed anticholinergic medication along with CIC. However, her caregivers reported that the treatment did not alleviate her symptoms, and they soon discontinued the regimen due to a limited understanding of her conditions, lack of guidance on CIC techniques, and difficulties in positioning or managing the patient's pain during catheterization. She did not practice urotherapy exercises, such as pelvic floor or bladder training. Examination in this admission revealed OAB symptoms, including urinary urgency, frequency, nocturia, detrusor overactivity, reduced bladder capacity, and reduced sensation of bladder filling. She was provided with standard and specific urotherapies. Standard therapy included education about her condition, advice on adequate fluid intake, a bladder diary, and recommendations to record fluid intake and output. Specific therapy included bladder training, pelvic floor muscle exercises, double voiding, deferment exercises, and timed voiding, along with 5 mg/day of oxybutynin. After six weeks of treatment, her OAB symptoms improved significantly, with no further detrusor overactivity, increased bladder capacity, and an overall improvement in quality of life. The combination of urological therapy, CIC, and anticholinergic medication can improve clinical symptoms and urodynamic parameters of OAB in children.