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Related Experiment Videos

Bladder dysfunction and neurological disability at presentation in closed spina bifida

L B Johnston1, M Borzyskowski

  • 1Department of Paediatric Neurology, Newcomen Centre, Guy's Hospital, London, UK.

Archives of Disease in Childhood
|October 15, 1998
PubMed
Summary

Congenital closed spinal anomalies like closed spina bifida can cause bladder dysfunction. Videourodynamic assessment is crucial for all patients to detect issues and prevent kidney damage.

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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.

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  • 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.