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Urinary continence in open myelomeningocele
Archives of Disease in Childhood
|September 1, 1977
Summary
Urinary continence is achieved by a minority of children with myelomeningocele by age 12. Early urinary diversion is recommended only to prevent kidney damage, not for incontinence alone.
Area of Science:
- Pediatric Surgery
- Urology
- Neurology
Background:
- Open myelomeningocele surgery in neonates can lead to long-term complications.
- Urinary incontinence is a common challenge for survivors of myelomeningocele.
- Assessing the long-term outcomes of urinary continence is crucial for patient management.
Purpose of the Study:
- To evaluate the rate of urinary continence in children treated for open myelomeningocele.
- To determine the appropriate indications for early urinary diversion in this population.
Main Methods:
- A consecutive series of 200 neonates undergoing open myelomeningocele surgery were followed.
- Urinary continence was assessed in survivors at 10 to 12 years of age.
- Neurological involvement and age at achieving urinary control were recorded.
Main Results:
- Out of 106 survivors at 10-12 years, 24 achieved urinary continence.
- This included 11 children with significant neurological deficits.
- Four children attained urinary control after age 5.
Conclusions:
- Urinary incontinence alone is not a sufficient indication for early urinary diversion in the first decade.
- Early urinary diversion should be reserved for preventing progressive renal function deterioration.
- Management decisions should consider individual neurological status and renal health in myelomeningocele patients.
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