Vibegron for Anticholinergic-Resistant Pediatric Neurogenic Lower Urinary Tract Dysfunction After Spinal Cord Amputation: A Case Report.

INTRODUCTION

Pediatric neurogenic lower urinary tract dysfunction (NLUTD) is commonly managed with anticholinergic agents and clean intermittent catheterization (CIC). However, treatment options are limited for patients who remain resistant to conventional therapy, particularly following spinal cord surgery.

CASE PRESENTATION: A 14-year-old boy with myelomeningocele underwent vertebral resection and spinal cord amputation. Despite CIC and solifenacin, he continued to experience daily urinary incontinence. 1 year postoperatively, his symptoms worsened and urinalysis became abnormal. Video-urodynamic study showed reduced bladder compliance and progression of bladder deformity. Vibegron 50 mg once daily was initiated. At 12 weeks, bladder capacity increased and compliance improved. Over 24 months, no urinary tract infections, incontinence episodes, or drug-related adverse events occurred.

CONCLUSION

This case suggests that vibegron may be an effective, well-tolerated add-on therapy for pediatric patients with anticholinergic-resistant NLUTD after spinal cord surgery, improving bladder function and morphology while helping maintain quality of life.