Urological outcome after myelomeningocele: 20 years of follow-up

Jørgen Mogens Thorup; Fin Biering-Sorensen; Dina Cortes

doi:10.1111/j.1464-410x.2010.09681.x

Urological outcome after myelomeningocele: 20 years of follow-up

Jørgen Mogens Thorup, Fin Biering-Sorensen, Dina Cortes

Department of Clinical Medicine

28 Citations (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.

Original language	English
Journal	B J U International (Print)
Volume	107
Issue number	6
Pages (from-to)	994-999
Number of pages	6
ISSN	1464-4096
DOIs	https://doi.org/10.1111/j.1464-410x.2010.09681.x
Publication status	Published - Mar 2011

Keywords

Adolescent
Adult
Child
Child, Preschool
Epidemiologic Methods
Female
Humans
Infant
Male
Meningomyelocele
Treatment Outcome
Urinary Bladder, Neurogenic
Urination Disorders
Urodynamics
Vesico-Ureteral Reflux
Young Adult

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10.1111/j.1464-410x.2010.09681.x

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title = "Urological outcome after myelomeningocele: 20 years of follow-up",

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.",

keywords = "Adolescent, Adult, Child, Child, Preschool, Epidemiologic Methods, Female, Humans, Infant, Male, Meningomyelocele, Treatment Outcome, Urinary Bladder, Neurogenic, Urination Disorders, Urodynamics, Vesico-Ureteral Reflux, Young Adult",

author = "Thorup, {J{\o}rgen Mogens} and Fin Biering-Sorensen and Dina Cortes",

note = "{\textcopyright} 2010 THE AUTHORS. BJU INTERNATIONAL {\textcopyright} 2010 BJU INTERNATIONAL.",

year = "2011",

month = mar,

doi = "10.1111/j.1464-410x.2010.09681.x",

language = "English",

volume = "107",

pages = "994--999",

journal = "BJU International",

issn = "1464-4096",

publisher = "Wiley-Blackwell",

number = "6",

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TY - JOUR

T1 - Urological outcome after myelomeningocele: 20 years of follow-up

AU - Thorup, Jørgen Mogens

AU - Biering-Sorensen, Fin

AU - Cortes, Dina

PY - 2011/3

Y1 - 2011/3

N2 - 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.

AB - 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.

KW - Adolescent

KW - Adult

KW - Child

KW - Child, Preschool

KW - Epidemiologic Methods

KW - Female

KW - Humans

KW - Infant

KW - Male

KW - Meningomyelocele

KW - Treatment Outcome

KW - Urinary Bladder, Neurogenic

KW - Urination Disorders

KW - Urodynamics

KW - Vesico-Ureteral Reflux

KW - Young Adult

U2 - 10.1111/j.1464-410x.2010.09681.x

DO - 10.1111/j.1464-410x.2010.09681.x

M3 - Journal article

C2 - 20860652

SN - 1464-4096

VL - 107

SP - 994

EP - 999

JO - BJU International

JF - BJU International

IS - 6

ER -

Urological outcome after myelomeningocele: 20 years of follow-up

Abstract

Keywords

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