Related Experiment Videos
Neurovesical dysfunction due to spinal dysraphism in anorectal anomalies
M L Capitanucci1, M Rivosecchi, M Silveri
1Division of Pediatric Surgery, Bambino Gesù Children's Hospital, Rome, Italy.
Summary
Spinal dysraphism (SD) is linked to anorectal anomalies (ARA) and urinary dysfunction. Early spinal cord evaluation is crucial in children with ARA to identify potential neurovesical issues.
Area of Science:
- Pediatric Urology
- Neurology
- Developmental Biology
Background:
- Spinal dysraphism (SD) is associated with functional abnormalities in children with anorectal anomalies (ARA).
- The incidence of SD in ARA patients may be underestimated.
- Routine neuroradiological investigation of lower urinary tract function is not standard practice.
Purpose of the Study:
- To evaluate urodynamic (UDS) findings in children with ARA and confirmed SD.
- To investigate the relationship between age, SD, and neurovesical dysfunction in ARA patients.
Main Methods:
- Urodynamic (UDS) evaluations were performed on 14 patients (8 males, 6 females) with ARA and SD.
- Patients were divided into two age groups: Group A (5-18 months) and Group B (3-12 years).
- UDS findings were classified as upper motor neuron (UMN) or lower motor neuron (LMN) lesions.
Main Results:
- In Group A (infants), 5 of 9 children had normal UDS; 4 showed UMN lesion patterns.
- In Group B (older children), 1 of 5 had normal UDS; 4 had pathological findings (2 UMN, 2 LMN lesions).
- Pathological UDS findings were more prevalent in older children, suggesting SD may be asymptomatic in younger patients.
Conclusions:
- Neurovesical dysfunction in children with ARA is likely associated with spinal dysraphism (SD).
- Early morphological evaluation of the spinal cord is essential for all children with ARA before surgical correction.
- The lower incidence of abnormal UDS in younger children suggests SD may be present but asymptomatic.