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Neurovesical dysfunction in patients with anorectal malformations
1Department of Pediatric Surgery, Cerrahpaşa Medical Faculty, University of Istanbul, Turkey.
Summary
Neurovesical dysfunction (NVD) is common in patients with operated anorectal malformations (ARM), particularly those with supralevator ARM or sacral abnormalities. Urodynamic testing is recommended for suspected NVD in ARM patients.
Area of Science:
- Pediatric Surgery
- Urology
- Developmental Biology
Background:
- Anorectal malformations (ARM) can lead to complex health issues.
- Neurovesical dysfunction (NVD) is a potential complication affecting bladder function in these patients.
Purpose of the Study:
- To determine the incidence of NVD in patients with operated ARM.
- To explore the relationship between NVD and sacral abnormalities in this cohort.
Main Methods:
- The study involved 33 patients operated for anal atresia, aged 1-17 years.
- Cystometric and electromyography investigations were used for urodynamic assessment.
- Patients were categorized based on ARM level (supralevator/infralevator) and presence of sacral abnormalities.
Main Results:
- NVD was observed in 45.4% of patients.
- The incidence of NVD was significantly higher in patients with supralevator ARM (70%) and sacral abnormalities (64.2%).
- Patients with infralevator ARM or no sacral abnormalities also showed NVD, indicating it's not exclusive to severe cases.
Conclusions:
- NVD is a significant concern in operated ARM patients, especially with supralevator malformations and sacral anomalies.
- The absence of these specific indicators does not rule out NVD.
- Routine urodynamic investigations are crucial for early detection and management of NVD in all ARM patients.