Urological outcome after myelomeningocele: 20 years of follow-up

Jørgen Mogens Thorup, Fin Biering-Sorensen, Dina Cortes

28 Citationer (Scopus)

Abstract

OBJECTIVE: • To evaluate the urological outcome in a long-term follow-up of individuals with myelomeningocele and relate the findings obtained to urodynamic variables in childhood. PATIENTS AND METHODS: • Individuals with myelomeningocele born from 1964-1988 were included at time of urodynamic investigation. • Age at inclusion was in the range from 1 month to 19.5 years (median, 6 years). • Detrusor function was classified as overactive, underactive or non-contractile. • Urethral function was classified according to the leak point pressure. • In childhood and at follow-up, kidney function was estimated with renography and isotope-glomerular filtration rate examinations. RESULTS: • In total, 52 individuals (28 boys and 24 girls) aged 19-41 years (median, 29 years) had follow-up. • Of these, 37 (71%) individuals had bilateral normal kidney function at followup; seven (14%) had normal total rena function but unilateral deteriorated kidney, and eight individuals (15%) had deteriorated kidney function. • Adult individuals with bilateral kidney deterioration had a significant higher frequency of diagnosed detrusor overactivity at childhood urodynamics (63%) compared to those with normal function of both kidneys (24%). In total, 48% of the 52 myelomeningocele individuals were continent at follow-up. • Continence surgery was performed in eight patients, nine used anticholinergica, three had regular botulinum toxin detrusor injections, and 27 used clean intermittent catheterization. CONCLUSIONS: • Overall, 15% of patients had impairment of kidney function and 48% were urinary continent. • Considering the present age distribution of the present study population, this figure appears to be comparable to the data in the iterature. • Urodynamic findings in childhood were predictive for later kidney deterioration.

OriginalsprogEngelsk
TidsskriftB J U International (Print)
Vol/bind107
Udgave nummer6
Sider (fra-til)994-999
Antal sider6
ISSN1464-4096
DOI
StatusUdgivet - mar. 2011

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