Comparison of neurogenic lower urinary tract dysfunctions in open versus closed spinal dysraphism: A prospective cross‐sectional study of 318 patients

Peyronnet, B.; Brochard, Charlène; Jezequel, Magali; Hascoët, J.; Alimi, Q.; Senal, N.; Carsin-Nicole, Béatrice; Riffaud, Laurent; Reste, Pierre-Jean Le; Olivari-Philiponnet, C.; Siproudhis, L.; Kerdraon, J.; Gamé, X.; Manunta, A.

doi:10.1002/nau.23782

Cited by 9 publications

(9 citation statements)

References 30 publications

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“…It was also found that bladder function of children with open SD particularly were different from both newborns with closed SD and healthy newborns. As in other studies of children with closed spinal dysraphism we found a great variation in bladder function, ranging from normal function to VOP findings like those in the open SD group [10,30,31]. The study also gives evidence that if a newborn during VOP leaks at provocation or does not void with a stream, neurogenic bladder-sphincter dysfunction (NBSD) should be suspected and further evaluated, as if the child voids more frequently than 7 times during VOP or does not void at all during the 4 h of observation.…”

Section: Discussionsupporting

confidence: 86%

“…On the other hand, in infants with closed spinal dysraphism, i.e. with intact skin coverage of the spine, there is a greater variation in bladder function ranging from completely normal to bladder dysfunction with high risk of renal damage [10]. Recommendations from the International Children's Continence Society regarding management considering both the anatomical subtype of closed SD and the clinical situation has been published [4].…”

Section: Introductionmentioning

confidence: 99%

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Four-hour voiding observation with provocation test reveals significant abnormalities of bladder function in newborns with spinal dysraphism

Wide

Duchén

Mattsson

et al. 2020

Journal of Pediatric Urology

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Conclusion Newborns with spinal dysraphism differ from healthy newborns in many aspects of bladder function. Bladder function varies between newborns with closed and open spinal dysraphism. Many newborns with spinal dysraphism leak at bladder provocation and void without a stream but healthy newborns do not. Early determination of post-void residuals is mandatory in children with spinal dysraphism and non-invasive VOP gives this information in a standardized way, also adding information on frequency, voiding with a stream and leakage at provocation.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Four-hour voiding observation with provocation test reveals significant abnormalities of bladder function in newborns with spinal dysraphism

Wide

Duchén

Mattsson

et al. 2020

Journal of Pediatric Urology

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“…60 Spinal dysraphism is a common reason for neurogenic lower urinary tract dysfunction. 21,[61][62][63][64] The evaluation of bladder function is currently not properly assessed prenatally. While cycles of bladder emptying and refilling are observed in routine anatomical scans, no metric parameters have been suggested to assess the function.…”

Section: Patientmentioning

confidence: 99%

Prenatal diagnosis and postnatal outcome of closed spinal dysraphism

Bedei,

Krispin,

Sanz Cortes

et al. 2023

Prenatal Diagnosis

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ObjectiveTo evaluate the prenatal diagnosis of closed dysraphism (CD) and its correlation with postnatal findings and neonatal adverse outcomes.MethodsA retrospective cohort study including pregnancies diagsnosed with fetal CD by prenatal ultrasound (US) and magnetic resonance imaging (MRI) at a single tertiary center between September 2011 and July 2021.ResultsCD was diagnosed prenatally and confirmed postnatally in 12 fetuses. The mean gestational age of prenatal imaging was 24.2 weeks, in 17% the head circumference was ≤fifth percentile and in 25% the cerebellar diameter was ≤fifth percentile. US findings included banana sign in 17%, and lemon sign in 33%. On MRI, posterior fossa anomalies were seen in 33% of cases, with hindbrain herniation below the foramen magnum in two cases. Mean clivus‐supraocciput angle (CSA) was 74°. Additional anomalies outside the CNS were observed in 50%. Abnormal foot position was demonstrated prenatally in 17%. Neurogenic bladder was present in 90% of patients after birth.ConclusionArnold Chiari II malformation and impaired motor function can be present on prenatal imaging of fetuses with CD and may be associated with a specific type of CD. Prenatal distinction of CD can be challenging. Associated extra CNS anomalies are frequent and the rate of neurogenic urinary tract dysfunction is high.

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“…Both of them may cause neurogenic bladder (NB) through the main mechanism of tethered cord syndrome (TCS), though the odds for the development of NB are smaller for the latter. [1] Recent improved perinatal screening tests reveal increasing number of closed SD without evidence for TCS. Surgical indication for this group of patients has not been standardized, while most surgeons would agree that not all patients require preventive surgery.…”

Section: Introductionmentioning

confidence: 99%

“…Spinal dysraphism (SD) is an umbrella term referring to the group of the congenital spine and spinal cord defects and can be classified into open and closed types. Both of them may cause neurogenic bladder (NB) through the main mechanism of tethered cord syndrome (TCS), though the odds for the development of NB are smaller for the latter [ 1 ]. Recent improved perinatal screening tests reveal increasing number of closed SD without evidence for TCS.…”

Section: Introductionmentioning

confidence: 99%

Preoperative Videourodynamic Study Is Helpful in Predicting Long-term Postoperative Voiding Function in Asymptomatic Patients With Closed Spinal Dysraphism

Kim

Jung

et al. 2022

Int Neurourol J

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Purpose: Controversy exists regarding the role preoperative urodynamic study for asymptomatic closed spinal dysaraphism as it has failed to reveal the benefit in surgical decision and expectation of urological outcomes.We explore the relationship between preoperative videourodynamic study and postoperative urological outcomes after toilet training completed, focusing on their capability of spontaneous voiding. Methods:We retrospectively reviewed the data of 181 patients who underwent preventive spinal cord untethering and followed at least till the completion of toilet training. Before untethering, patients underwent preoperative videourodynamic study. Postoperative voiding function was evaluated in three phases 1) till postoperative 6 months 2) till the completion of toilet training 3) two years after toilet training. Changing distribution of emptying pattern at each period was described. Also, relevance to preoperative urodynamic parameters on spontaneous voiding and urinary continence after toilet training was assessed. Results: Spinal lipoma and low-lying conus were found in 145 (80%) and 128 (70.7%) patients, respectively. Spontaneous voiding was found in 125 (69.1%), 164 (90.6%) and 162 (89.5%) patients at postoperative 6 months, till the toilet training and two years after toilet training, respectively. Videourodynamics helped to clarify the presence of vesicourethral synergy. This was correlated with spontaneous voiding at postoperative 6 months and better urinary continence after 2 years of toilet training. Conclusions: Eventual spontaneous voiding was achieved till toilet training in 90% patients following preventive untethering. Those showing preoperative vesicourethral synergy was associated with faster achievement of spontaneous voiding and better urinary continence when they enter elementary school.

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Comparison of neurogenic lower urinary tract dysfunctions in open versus closed spinal dysraphism: A prospective cross‐sectional study of 318 patients

Cited by 9 publications

References 30 publications

Four-hour voiding observation with provocation test reveals significant abnormalities of bladder function in newborns with spinal dysraphism

Four-hour voiding observation with provocation test reveals significant abnormalities of bladder function in newborns with spinal dysraphism

Prenatal diagnosis and postnatal outcome of closed spinal dysraphism

Preoperative Videourodynamic Study Is Helpful in Predicting Long-term Postoperative Voiding Function in Asymptomatic Patients With Closed Spinal Dysraphism

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