Bladder dysfunction and neurological disability at presentation in closed spina bifida

Area of Science:

• Pediatric Neurology
• Urology

Background:

• Congenital closed spinal anomalies can lead to significant neurological and urological complications.
• These anomalies often involve the spinal cord and nerve roots, impacting lower limb function and bladder control.
• Neuropathic bladder dysfunction is a common and serious consequence, increasing the risk of renal damage.

Purpose of the Study:

• To investigate the clinical and videourodynamic findings in patients with closed spina bifida.
• To evaluate the reliability of clinical assessments and voiding behavior history in identifying bladder dysfunction.
• To determine the necessity of videourodynamic assessment in managing these patients.

Main Methods:

• A cohort of 51 patients with closed spina bifida was studied.
• Clinical neurological examinations and voiding behavior were recorded.
• Renal tract ultrasonography and videourodynamic assessments were performed.

Main Results:

• Most patients (33/51) had normal or minor neurological findings.
• While 21/51 had normal renal tract ultrasonography, only 2/51 showed normal videourodynamics.
• A significant majority (31/51) exhibited two or more abnormalities during videourodynamic assessment.
• Clinical assessment and voiding history were unreliable indicators of bladder dysfunction.

Conclusions:

• Clinical neurological assessment and voiding behavior history are insufficient to identify bladder dysfunction in closed spina bifida.
• Videourodynamic assessment is essential for all patients diagnosed with or suspected of having closed spina bifida.
• Early and accurate diagnosis of bladder dysfunction via videourodynamics is critical for preventing renal damage.