Predictive value of initial urodynamic pattern on urinary continence in patients with myelomeningocele

Kessler, Thomas M.; Lackner, Jakob; Kiss, Gustav; Rehder, Peter; Madersbacher, H.

doi:10.1002/nau.20230

Cited by 24 publications

(8 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We agree with Kessler et al [27] that the initial urodynamic pattern is very useful in predicting urinary continence in MMC, but we have to remember that social continence does not mean a safe upper urinary tract. Social isolation of MMC patients depends on correct bladder function and could be diminished by proper diagnostics.…”

Section: Discussionsupporting

confidence: 89%

Urodynamic Findings and Renal Function in Children with Neurogenic Bladder after Myelomeningocele

et al. 2015

View full text Add to dashboard Cite

Introduction: Myelomeningocele (MMC) is a congenital central nervous system malformation caused by a failure of the neurulation process in early pregnancy. Patients with MMC present many abnormalities and the nervous, skeletal and urinary systems are the most affected. The aim of this study was to clinically evaluate patients with MMC, estimate renal and lower urinary tract (LUT) function and to ascertain whether urodynamic findings can predict the deterioration of urinary tract function. Materials and Methods: Medical records of 112 patients were gathered from a database and evaluated retrospectively. The data included age, sex, BMI Z-score WHO, physical activity, urodynamic parameters and diagnosis and renal function. Results: A total of 112 patients with MMC were enrolled in the study. There were no differences in age, sex, BMI Z-score WHO, physical activity, renal function and urodynamic findings (apart from cystometric capacity) between boys and girls. Detrusor overactivity was the most frequent urodynamic diagnosis in all groups of physical activity, level of lesion and in catheterized and non-catheterized children. The correlations between urodynamic findings and renal function tests were found. Conclusions: Patients with neurogenic bladder after MMC most often present detrusor overactivity. LUT function is disturbed in all MMC patients independent of lesion level and physical activity.

show abstract

Section: Discussionsupporting

confidence: 89%

Urodynamic Findings and Renal Function in Children with Neurogenic Bladder after Myelomeningocele

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Spina bifida affects bladder function due to inadequate bladder wall development and thus leads to poor bladder filling and increased postvoid residual volume 29 causing lifelong morbidity in more than 90% of children. 30,31 Both of these manifest with increased postvoid residual volumes requiring intermittent bladder catheterization. 32,33 In this study, we evaluated postvoid residual volumes in the lambs using 2D ultrasound.…”

Section: Discussionmentioning

confidence: 99%

Neurological Outcomes after Human Umbilical Cord Patch for In Utero Spina Bifida Repair in a Sheep Model

Papanna

Mann

Snowise

et al. 2016

AJP Rep

View full text Add to dashboard Cite

Objectives The objective of our study was to test the hypothesis that in utero repair of surgically created spina bifida in a sheep model using cryopreserved human umbilical cord (HUC) patch improves neurological outcome. Methods Spina bifida with myelotomy was surgically created in timed pregnant ewes at gestational day (GD) 75. The fetuses were randomly assigned to unrepaired versus HUC and treated at GD 95 and then delivered at GD 140. Neurological evaluation was performed using the Texas Spinal Cord Injury Scale (TSCIS), bladder control using ultrasound, and the hindbrain herniation. Results Three lambs without the spina bifida creation served as controls. There were four lambs with spina bifida: two were unrepaired and two underwent HUC repair. The control lambs had normal function. Both unrepaired lambs had nonhealed skin lesions with leakage of cerebrospinal fluid, a 0/20 TSCIS score, no bladder control, and the hindbrain herniation. In contrast, both HUC lambs had a completely healed skin defect and survived to day 2 of life, a 3/20 and 4/20 TSCIS score (nociception), partial bladder control, and normal hindbrain anatomy. Conclusions Cryopreserved HUC patch appears to improve survival and neurological outcome in this severe form of the ovine model of spina bifida.

show abstract

“…Only urodynamics together with the targeted clinical investigation (presence of anal/bulbocavernosus re£ex) allow de¢nition of the dysfunctional pattern of the lower urinary tract [Kessler et al, 2006] for detecting risk factors (low-bladder compliance, intravesical pressure >40 cmH 2 O, detrusor sphincter dyssynergia) in time before major changes in the upper urinary tract occur. They are decisive for the therapeutic strategy.…”

Section: Discussionmentioning

confidence: 99%

Early proactive management improves upper urinary tract function and reduces the need for surgery in patients with myelomeningocele

Kessler

Lackner

Kiss

et al. 2006

Neurourology and Urodynamics

Self Cite

View full text Add to dashboard Cite

show abstract

Predictive value of initial urodynamic pattern on urinary continence in patients with myelomeningocele

Abstract: The initial urodynamic pattern is very useful in counseling families by predicting urinary continence in patients with myelomeningocele. The chances of becoming continent or at least socially dry are best for patients with overactive (spastic) sphincter.

Cited by 24 publications

References 23 publications

Urodynamic Findings and Renal Function in Children with Neurogenic Bladder after Myelomeningocele

Urodynamic Findings and Renal Function in Children with Neurogenic Bladder after Myelomeningocele

Neurological Outcomes after Human Umbilical Cord Patch for In Utero Spina Bifida Repair in a Sheep Model

Early proactive management improves upper urinary tract function and reduces the need for surgery in patients with myelomeningocele

Contact Info

Product

Resources

About