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Occult spinal dysraphism: neurogenic voiding dysfunction and long-term urologic follow-up
M Silveri1, M L Capitanucci, N Capozza
1Divisione di Chirurgia Pediatrica, Ospedale "Bambino Gesù", P.zza S. Onofrio 4, I-000165, Rome, Italy.
Pediatric Surgery International
|February 1, 1997
Summary
This study followed 55 children with occult spinal dysraphism (OSD), finding that 78% achieved urinary continence long-term. Early intervention and management are crucial for preserving renal function in OSD patients.
Area of Science:
- Pediatric Urology
- Neuroscience
- Developmental Biology
Background:
- Occult spinal dysraphism (OSD) is a congenital condition affecting spinal cord development.
- Early diagnosis and management are critical for preventing long-term complications.
- Urinary incontinence and renal deterioration are significant concerns in OSD patients.
Purpose of the Study:
- To evaluate long-term urinary continence and renal function in children with OSD.
- To compare outcomes in patients who underwent neurosurgery versus those who did not.
- To analyze the impact of various management strategies on OSD progression.
Main Methods:
- Longitudinal follow-up of 55 children diagnosed with OSD between 1976 and 1994.
- Comprehensive neurourologic and urodynamic evaluations at diagnosis and during follow-up.
- Analysis of treatment interventions including neurosurgery, intermittent catheterization, and surgical procedures for vesicoureteral reflux and incontinence.
Main Results:
- Urinary incontinence affected all patients during the evolution of OSD.
- Socially acceptable continence was achieved in 78% of children at long-term follow-up (6-18 years).
- Renal failure occurred in 8% of patients; vesicoureteral reflux was managed with endoscopic procedures or bladder augmentation.
Conclusions:
- Effective management strategies can lead to good long-term urinary continence in OSD patients.
- Proactive monitoring and intervention are essential for preventing renal function deterioration.
- Neurosurgical intervention timing and other management approaches warrant further investigation for optimal OSD care.