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Vesicoureteral reflux often presents at birth in infants with meningomyelocele and tends to improve spontaneously. Urinary tract infections are common, particularly recurrent infections and upper tract anomalies in those with high spinal lesions.
Area of Science:
- Pediatric Urology
- Neonatal Medicine
- Nephrology
Background:
- Meningomyelocele is a congenital condition affecting spinal cord development.
- Vesicoureteral reflux (VUR) is a common comorbidity in infants with meningomyelocele.
- Urinary tract infections (UTIs) pose a significant risk in this patient population.
Purpose of the Study:
- To investigate the incidence and natural history of VUR in neonates with meningomyelocele.
- To assess the occurrence of asymptomatic and recurrent UTIs in infants with meningomyelocele.
- To explore the relationship between spinal lesion level and upper urinary tract anomalies.
Main Methods:
- Retrospective analysis of 100 infants diagnosed with meningomyelocele.
- Evaluation of VUR presence at birth and during infancy.
- Monitoring for urinary tract infections and upper tract anomalies.
Main Results:
- Vesicoureteral reflux was detected at birth in 24% of the infants.
- A significant tendency for spontaneous VUR improvement was observed during infancy.
- 16% experienced a single asymptomatic UTI, while 33% had recurrent infections.
- Higher spinal lesions correlated with a greater incidence of upper tract anomalies.
Conclusions:
- Early-onset VUR in meningomyelocele patients often shows spontaneous resolution.
- Recurrent UTIs and upper tract anomalies are significant concerns, especially with high spinal lesions.
- Close monitoring for VUR and UTIs is crucial in infants with meningomyelocele.
Abstract:
Reflux was present at birth in 24 per cent of 100 babies with meningomyelocele, indicating a marked tendency toward spontaneous improvement in infancy. Reflux starts in some children after birth but the number is too small to draw definite conclusions on the cause of this onset. Of the children with myelomeningocele 16 per cent had asymptomatic infection of the urine on 1 occasion only and 33 per cent had recurrent infections. There was a greater incidence of upper tract anomalies in patients with a high level spinal lesion.