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Evaluation of the urinary tract in children with myelomeningocele
Insights
Myelomeningocele in children can lead to serious urinary tract issues, including upper urinary tract dilatation and bladder dysfunction. Regular urological surveillance is crucial for managing these complications.
Area of Science:
- Pediatric Urology
- Nephrology
- Neurology
Background:
- Myelomeningocele is a complex congenital condition affecting neurological and urological development.
- Urinary tract complications are common in children with myelomeningocele, impacting long-term health.
- Understanding the spectrum of urological issues is vital for effective patient management.
Purpose of the Study:
- To investigate the long-term urological outcomes in children with myelomeningocele.
- To identify the prevalence of upper urinary tract dilatation and bladder dysfunction.
- To discuss the importance of urological surveillance in this patient population.
Main Methods:
- Retrospective analysis of 43 children diagnosed with myelomeningocele.
- Assessment of survival rates, incidence of upper urinary tract dilatation.
- Evaluation of bladder compliance, detrusor hyperreflexia, and detrusor-sphincter dyssynergia.
Main Results:
- Two of 43 children died from obstructive nephropathy.
- Twelve of 30 long-term survivors (over 6 years) developed upper urinary tract dilatation.
- Bladder compliance above 20 was rare (4 patients); low pressure amplitude was common in detrusor hyperreflexia (11 patients).
- Detrusor-sphincter dyssynergia with large residual volumes was observed in 4 patients.
Conclusions:
- Myelomeningocele poses significant risks for progressive renal damage and bladder dysfunction.
- Upper urinary tract dilatation is a notable complication in long-term survivors.
- Continuous urological surveillance is essential for early detection and management of urinary complications.
Abstract:
Of 43 children suffering from myelomeningocele, 2 died of obstructive nephropathy; 30 survived for more than 6 years and 12 of these developed upper urinary tract dilatation. A bladder compliance above 20 was only found in 4 patients, while in 11 with detrusor hyperreflexia, a low pressure amplitude was generally observed. Detrusor-sphincter dyssynergia accompanied by large residual volumes was found in 4 patients. Surveillance of the urological condition is discussed.