The changing urodynamic pattern in infants with myelomeningocele

A total of 43 infants with spina bifida was evaluated with a standard simplified urodynamic technique to determine whether bladder behavior altered with development and the optimal timing for urodynamic testing. Using urodynamic evaluation plus renal ultrasound and voiding cystourethrography the patients were divided into 2 groups: 1) those with a favorable prognosis and 2) those with an unfavorable prognosis. Only 55% of the initial urodynamic studies were predictive of future clinical course. The patients who worsened generally did so in the first 6 months of life. Of the patients initially believed to have an unfavorable prognosis 86% improved or stabilized with therapy. Urodynamic testing appears to be an important adjunct at 6-month intervals in infancy and early childhood as bladder behavior continues to evolve.