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Neurogenic bladder dysfunction after sacrococcygeal teratoma resection.
Keramettin Ugur Ozkan1, Stuart B Bauer, Shahram Khoshbin
1Department of Urology, Children's Hospital Boston and Harvard Medical School, Boston, Massachusetts, USA.
The Journal of Urology
|January 13, 2006
Summary
Treatment for sacrococcygeal teratoma (SCT) in newborns can lead to significant urological issues. Urodynamic studies reveal common bladder and sphincter dysfunction, often requiring intervention to prevent upper urinary tract damage.
Area of Science:
- Pediatric Surgery
- Urology
- Neuro-urology
Background:
- Sacrococcygeal teratoma (SCT) treatment in newborns involves surgery and chemotherapy.
- Urological sequelae following this treatment are not well-documented.
- This review examines the urological and neurourological outcomes in infants treated for SCT.
Purpose of the Study:
- To investigate the urological and neurourological findings in infants treated for SCT in the newborn period.
- To analyze the long-term impact of SCT treatment on lower urinary tract function.
Main Methods:
- Retrospective review of infants with resected SCT undergoing urodynamic evaluation (1986-2004).
- Analysis of radiological, neurological, and urodynamic data.
- Evaluation of postoperative incontinence management strategies.
Main Results:
- 14 patients analyzed for bladder dysfunction post-SCT resection.
- Abnormal neurological exams (36%) and detrusor overactivity (8/14) were common.
- Sphincter dyssynergia (38%) and high rates of clean intermittent catheterization (79%) were observed.
- Significant incidence of hydronephrosis (6/14) and reflux (7/14) noted, often requiring surgical correction.
Conclusions:
- SCT treatment can cause significant neurourological dysfunction affecting the lower urinary tract.
- Abnormal bladder and urethral function, along with high-grade reflux, are potential complications.
- Comprehensive pre- and post-operative assessment, including urodynamic studies, is crucial.
- Ongoing monitoring is essential to preserve bladder function and prevent upper tract injury.