Urinary considerations for adult patients with spinal dysraphism

Abstract

The incidence of newborns with spinal dysraphism is diminishing worldwide, although survival of individuals with this condition into adulthood continues to improve. The number of adults with spinal dysraphism will, therefore, increase in the coming years, which will pose new challenges in patient management. Urological manifestations of spinal dysraphism can include increased risks of urinary incontinence, urinary tract infection, urinary calculi, sexual dysfunction, end-stage renal disease and iatrogenic metabolic disturbances; however, the severity and incidence of these symptoms varies substantially between patients. Owing to the presence of multiple comorbidities, treatment and follow-up protocols often have to be adapted to best suit the needs of specific patients. Authors describe bladder and kidney function and long-term complications of treatments initiated in childhood, as well as the potential for improvements in quality of life through better follow-up schedules and future developments.

Outcomes of intra‐detrusor injections of botulinum toxin in patients with spina bifida: A systematic review

“…Spina bifida has been for a long time considered as a pediatric disease . However, the improvement in medical management of this condition has led to a considerable increase in life expectancy with 50–94% of patients living into adulthood with most of them presenting problems related to neurological dysfunction of the lower urinary tract …”

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

“…Spinal dysraphism is the most common congenital cause of neurogenic bladder . Since the pioneering report by Tortori‐Donati and colleagues in 2000, spinal dysraphisms have usually been divided into open spinal dysraphisms (OSD) and closed spinal dysraphisms (CSD) .…”

“…2 Spinal dysraphism is the most common congenital cause of neurogenic bladder. 1,3,4 Since the pioneering report by Tortori-Donati and colleagues in 2000, spinal dysraphisms have usually been divided into open spinal dysraphisms (OSD) and closed spinal dysraphisms (CSD). 2 In OSD, the neural tissue is externally exposed through a congenital osseous defect while it is covered by skin in CSD.…”

Refractory Urinary Incontinence in Girls: The Role of the Bladder Neck

“…Proper innervation of the lower urinary tract is crucial for its normal function and good coordination between the bladder and the sphincter mechanism (3). Patients with neurogenic LUTD need close follow-up in a multidisciplinary setting to reduce the risk of damage of the upper urinary tract (12, 13). Clean intermittent catheterization and antimuscarinics are the first-line therapy and are highly effective in the most of the cases.…”