Hınman Syndrome: Insıdıous Course of Chronıc Kidney Dısease

Year 2019, Volume: 7 Issue: Ek - IRUPEC 2019 Kongresi Tam Metin Bildirileri, 209 - 213, 10.12.2019

Zehra Nihan Coşkun , Bülent Ataş

Abstract

Hinman syndrome (non-neurogenic neurogenic bladder); is a severe voiding dysfunction that significantly affects the upper urinary tract due to the discordance between detrusor contraction and sphincter relaxation without neurological dysfunction. Typically, patients have incomplete bladder emptying and chronic urinary retention, urinary incontinence, day and night urinary incontinence, fecal retention, recurrent urinary tract infections, and renal dysfunction. Typically, patients have incomplete bladder emptying and chronic urinary retention, urinary incontinence, day and night urinary incontinence, fecal retention, recurrent urinary tract infections, and renal dysfunction. In this article, two cases followed up in pediatric nephrology clinic due to chronic kidney disease caused by Hinman syndrome are discussed.
Cases: The first case; a 12-year-old female patient presented to our pediatric nephrology clinic with complaints of sudden urination and urinary incontinence for three months. At the time of admission GFR was calculated as 23.7 ml / min / 1.73m2 and bilateral hydronephrosis, bladder trabeculations and high detrusor pressure (51 cm / H2O) were determined. The second case; an 11-year-old male patient was presented to our clinic with the complaint of long-standing urinary urgency and daytime urinary incontinence. According to examinations GFR was found to be 34.5 ml / min / 1.73m2 and severe hydronephrosis on the right, diverticula in the bladder and high detrusor pressure (49 cm / H2O) were detected. Spinal magnetic resonance imaging was found to be normal in both cases and the cases were evaluated as chronic kidney disease developing because of Hinman syndrome.
Conclusion: Bladder-sphincter coordination disorder can cause damage to the bladder and upper urinary tract, leading to the development of neurogenic bladder and chronic kidney disease when early diagnosis and effective treatment is not applied. Families and clinicians should be aware that urinary urgency and day and night urinary incontinence are not benign in every child, and they should be aware that it can have very serious consequences. Clinicians should keep this syndrome in mind in order to recognize the preventable cause of chronic kidney disease such as Hinman syndrome early.

Keywords

Hinman syndrome

References

• References 1. Hinman F, Bauman FW (1973) Vesical and ureteral damage from voiding dysfunction in boys without neurologic or obstructive disease. J Urol 109:727–732 2. Rashid S,Waqar M, Khawaja AA, Arshad MS, SarwarMK (2011) Efficacy of transcutaneous nerve stimulation (TENS) therapy in overactive non-neurogenic neurogenic bladder (Hinman’s syndrome). Pak J Med Sci 27:528–532 3. Allen TD: The non-neurogenic neurogenic bladder. J Urol 1977; 117: 232. 4. McGuire EJ, Savastano JA (1984) Urodynamic studies in enuresis and the nonneurogenic neurogenic bladder. J Urol 132:299–302 5. Yılmaz AÇ, Buyukkaragoz B, Kivilcim S, Tayfur AC, Gunbey S. An adolescent boy progressing insidiously to end-stage renal disease: Answers. Pediatr Nephrol.2018 Mar;33(3):429-431. Epub 2017 Jun 19. PubMed PMID: 28631041. 6. Van Gool J, Tanagho EA. External sphincter activity and recurrent urinary tract infection in girls. Urology. 1977;10:348–53. 7. Robert M. Kliegman, Bonita F. Stanton, Nina F. Schor, Joseph W. St Geme Nelson Textbook of Pediatrics, 20th Edition Elsevier Inc, 1600 John F. Kennedy Blvd. Ste. 1800 Philadelphia, PA 19103-2899, p2583, 2016