Impact of spinal dysraphism on urinary and faecal prognosis in 25 cases of cloacal malformation

Muller, Cécile; Crétolle, Célia; Blanc, Thomas; Alova, Ilona; Jaı̈s, Jean-Philippe; Lortat-Jacob, S.; Aigrain, Yves; Zérah, Michel; Sarnacki, Sabine

doi:10.1016/j.jpurol.2014.05.012

Cited by 13 publications

(4 citation statements)

References 18 publications

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“…However, the studies are conflicting. Muller et al did not demonstrate an association between bowel function and length of common channel, abnormal sacral ratio, and presence of sacral or spinal anomalies in children with cloacal malformations 49 . Bowel function outcomes also did not differ in children with anorectal malformations who presented with and without spinal cord anomalies 50 .…”

Section: Discussionmentioning

confidence: 94%

Comparison of longitudinal and radial characteristics of intra‐anal pressures using 3D high‐definition anorectal manometry between children with anoretal malformations and functional constipation

Ambartsumyan

Shaffer

Carlin³

et al. 2020

Neurogastroenterology Motil

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Background Pathophysiology of fecal incontinence (FI) in children with anorectal malformations (AM) is not well understood. Standard or high‐resolution anorectal manometry (ARM) does not identify radial asymmetry or localize abnormal sphincter function. 3D high‐definition anorectal manometry (HDARM) provides detailed topographic and 3D pressure gradient representation of anal canal. Aims To compare intra‐anal pressure profiles between children with AM and controls using HDARM and to determine the association between manometric properties and reported predictors of fecal continence (AM type, spinal anomaly, and sacral integrity). Methods HDARM tracings of 30 children with AM and FI referred for ARM were compared with 30 age and sex‐matched children with constipation. 2D pressure profiles were used to measure length of high‐pressure zone (HPZ). Longitudinal and radial measurements of sphincter pressure at rest and squeeze were taken along each segment in 3D topographic views and compared between groups. Key Results 3D measurements demonstrated longitudinal and radial differences between groups along all quadrants of HPZ. At rest, intra‐anal pressures were lower along the four segments longitudinally across the anal canal and radially along the quadrants in AM group (P < .01). At squeeze, all quadrant pressures were lower in segments 1‐4 in AM group (P < .01). Sensation was abnormal in AM group (P < .01). Intra‐anal pressures longitudinally and radially were not associated with predictors of fecal continence. Conclusions and Inferences Children with AM had abnormal sensation and lower pressures longitudinally and radially along all quadrants of anal canal. Manometric properties at rest were not associated with reported predictors of fecal continence.

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Section: Discussionmentioning

confidence: 94%

Comparison of longitudinal and radial characteristics of intra‐anal pressures using 3D high‐definition anorectal manometry between children with anoretal malformations and functional constipation

Ambartsumyan

Shaffer

Carlin³

et al. 2020

Neurogastroenterology Motil

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“…Usually, it is described as a dark triangular structure with a tapered end. An atypical configuration with truncated end is often associated with other malformations, especially sacral agenesis and caudal regression syndrome [22]. …”

Section: Discussionmentioning

confidence: 99%

Sonographic Evaluation of Fetal Conus Medullaris and Filum Terminale

et al. 2016

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Background: Sonographic evaluation of the fetal conus medullaris (CM) level is not reproducible. The objectives of this study were to determine the normal position of the fetal CM during pregnancy as well as the normal intradural filum terminale (FT) length and to evaluate their use in detecting tethered cord. Methods: This is a prospective evaluation of normal singleton pregnancies examined by sonography from 17 weeks of gestation to term. Each sonographer had to identify the top of the first sacral vertebra (S1) to measure the distance between it and the conus extremity (CM-S1 distance). The intradural FT distance was measured with 5- to 8-MHz probes. Results: 194 consecutive pregnant women were included. The CM and intradural FT were demonstrated clearly in 164 (84%) cases. The mean CM-S1 distance was 20.6 mm (range 0.5-42). The mean intradural FT distance was 27.9 mm (range 6.6-49.3). Linear regression analysis showed a significant association between both those distances and gestational age (p < 0.05). In cases of tethered cord, the mean CM-S1 distance and the mean intradural FT distance were both below the 5th percentile. Conclusion: Prenatal evaluation of the CM and the intradural FT is feasible and reproducible and seems useful in detecting tethered cord.

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“…The presence of spinal anomalies (including lipomata, tethered cord or variations of dysraphism) and sacral bone anomalies (including sacral dysgenesis or agenesis) are also associated with abnormalities of sacral nerve and peripheral development both of which diminish the potential to achieve normal continence. 19,20 Therapeutics; current surgical strategies Strict midline dissection (posterior sagittal approach) for the reconstruction of ARM was proposed by Peña and DeVries to allow a better anatomical view and reduce the risk of collateral nerve damage. 21 This remains a principle for patients with CM.…”

Section: Diagnostics To Determine Anatomy -Recent Developmentsmentioning

confidence: 99%

Reconsidering Diagnosis, Treatment, and Postoperative Care in Children with Cloacal Malformations

Versteegh

Gardner

Scriven

et al. 2021

Journal of Pediatric and Adolescent Gynecology

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Impact of spinal dysraphism on urinary and faecal prognosis in 25 cases of cloacal malformation

Cited by 13 publications

References 18 publications

Comparison of longitudinal and radial characteristics of intra‐anal pressures using 3D high‐definition anorectal manometry between children with anoretal malformations and functional constipation

Comparison of longitudinal and radial characteristics of intra‐anal pressures using 3D high‐definition anorectal manometry between children with anoretal malformations and functional constipation

Sonographic Evaluation of Fetal Conus Medullaris and Filum Terminale

Reconsidering Diagnosis, Treatment, and Postoperative Care in Children with Cloacal Malformations

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