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Bladder function in congenital non-cystic spinal abnormalities
Insights
Congenital spinal anomalies in children can cause bladder dysfunction, leading to incontinence. Management varies, with some cases improving spontaneously and others requiring interventions like catheterization.
Area of Science:
- Pediatric Urology
- Neurology
- Developmental Biology
Background:
- Congenital spinal anomalies are a known cause of lower urinary tract dysfunction in children.
- These anomalies can affect bladder and urethral function, leading to various types of incontinence.
- Understanding the specific anomaly is crucial for effective management.
Purpose of the Study:
- To describe bladder function disturbances in children with congenital non-cystic spinal anomalies.
- To differentiate between types of bladder dysfunction based on spinal anomaly classification.
- To evaluate the effectiveness of different management strategies.
Main Methods:
- Retrospective analysis of 11 children with congenital non-cystic spinal anomalies.
- Classification of spinal anomalies into segmental (e.g., sacral agenesis) and dysraphic (e.g., lipomata, kyphoscoliosis) groups.
- Utilized manometric studies of the bladder and urethra to assess functional disturbances.
Main Results:
- Segmental anomalies (sacral agenesis) were associated with incontinence without bladder distension.
- Dysraphic anomalies (lipomata, kyphoscoliosis) were linked to incontinence due to retention with overflow.
- Manometric studies aided in distinguishing functional bladder disturbances.
Conclusions:
- Congenital spinal anomalies present diverse bladder functional disturbances in children.
- Classification of spinal anomalies helps predict the type of bladder dysfunction.
- Management approaches including observation, pharmacotherapy, and intermittent catheterization can be effective.
Abstract:
Disturbances of bladder function in 11 children with congenital non-cystic spinal anomalies are described. The spinal anomalies were divided into 2 groups, segmental and dysraphic. The segmental group comprised 6 children with sacral agenesis : their bladder disturbance was characterised by incontinence without bladder distension. The dysraphic group contained 5 children who had lesions such as intra thecal lipomata or severe kypho-scoliosis : they had incontinence due to retention with overflow. Manometric studies of the bladder and urethra were helpful in differentiating the types of functional disturbance. In some children incontinence improved spontaneously, others were helped by pharmacological agents or by intermittent catheterisation.