Uroneurological assessment of spina bifida cystica and occulta

Sakakibara, Ryuji; Hattori, Takamichi; Uchiyama, Tomoyuki; Kamura, Koichi; Yamanishi, Tomonori

doi:10.1002/nau.2150

Cited by 61 publications

(36 citation statements)

References 25 publications

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“…Whereas urinary retention in elderly men is mostly attributed to prostate hypertrophy, urinary retention in childhood, young adults and in women is very uncommon [1], which may have a neurological etiology [2]. Spina bifida occulta is such a disorder that causes urinary retention without marked neurological abnormality, other than sacral hypesthesia [3]. Although aseptic meningitis is a common neurological disorder, a combination of acute urinary retention and aseptic meningitis has not previously been well known.…”

Section: Introductionmentioning

confidence: 99%

Meningitis–retention syndrome

et al. 2005

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Section: Introductionmentioning

confidence: 99%

Meningitis–retention syndrome

et al. 2005

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“…In such patients, neurophysiologic methods can be used as an adjunct to the neurologic examination and imaging studies [35]. Among patients with voiding dysfunction, those with a positive neurologic history and examination have the greatest diagnostic yield and are best suited to pudendal SEP testing [13,36].…”

Section: Infrapontine-suprasegmental (Spinal) Diseasementioning

confidence: 99%

Neurophysiologic Testing in Neurogenic Bladder Dysfunction: Practical or Academic?

Podnar

2010

Curr Bladder Dysfunct Rep

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For the diagnosis of neurogenic bladder, in addition to clinical assessment, neurophysiologic testing may be useful. Neurophysiologic tests are more useful in patients with sacral compared with suprasacral disorders. Anal sphincter electromyography (EMG) is the most useful diagnostic test, particularly for focal sacral lesions and atypical parkinsonism. Another clinically useful method that tests the sacral segments and complements EMG is the sacral (penilo/clitoro-cavernosus) reflex. Kinesiologic EMG is useful to demonstrate detrusor sphincter dyssynergia. Somatosensory-evoked potential and motor-evoked potential studies may be useful to diagnose clinically silent central lesions. The utility of cortical somatosensoryevoked potential in bladder/urethra stimulation is limited by technical difficulties that can be partially overcome by the concomitant recording of a palmar sympathetic skin response. Sympathetic skin response recorded from the saddle region is also useful for testing the lumbosacral sympathetic system. A clinically useful neurophysiologic test for evaluating the sacral parasympathetic system is still lacking.

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“…L'intensité des symptômes est classée en légère (SSPI < 7), modérée (8 < SSPI < 19) et sévère (SSPI > 20). La tolérance aux symptômes urinaires est classée en bonne (0-1), moyenne (2-4) et mauvaise (5)(6) [10].…”

Section: Questionnairesunclassified

“…Actuellement, ils deviennent adultes [4]. Ces patients sont à haut risque de complications urologiques [5][6][7]. Ainsi, un suivi régulier de la fonction urinaire est nécessaire [5,8,9].…”

Section: Introductionunclassified

Évaluation du suivi urologique à l’âge adulte des spina bifida avec une myéloméningocèle

Gamé¹,

Moscovici

Bouali

et al. 2007

Pelv Perineol

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Objectifs : Évaluer le suivi urologique des jeunes adultes spina bifida avec une myéloméningocèle et déterminer des facteurs prédictifs de ce suivi. Matériel et méthodes : Entre novembre 2003 et février 2004, une étude transversale a été menée auprès de 131 adultes de plus de 18 ans ayant été consécutivement pris en charge pendant leur enfance en chirurgie pédiatrique viscérale pour une myéloméningocèle. Un autoquestionnaire portant sur les dates des dernières consultations médicales et de la dernière étude du haut appareil urinaire (créatininémie, échographie rénale) et sur la fonction mictionnelle a été adressé par courrier. Les données du dossier hospitalier de chirurgie pédia-trique ont été recueillies.Résultats : Le taux de réponses était de 62,6 %. Durant les deux dernières années, 43 % des répondeurs n'avaient pas eu de suivi spécialisé urologique, 46 % de dosage de la créatininémie et 35 % d'échographie rénale. Les patients ayant consulté en urologie avaient plus d'infections urinaires que ceux qui n'avaient pas consulté (3,2 AE 3,5 vs 1,4 AE 1,9, p = 0,045, test t de Student). Ces derniers avaient plus fréquemment un défaut de relaxation urétrale (29,2 vs 13,1 %, p = 0,026, test exact de Fisher).Conclusion : Le suivi à l'âge adulte des spina bifida avec une myéloméningocèle est insuffisant. Les patients consultant en urologie ont plus d'infections urinaires. À l'inverse, les patients ne consultant pas ont plus fréquemment un défaut de relaxation urétrale.Abstract: Objectives: To assess urological follow-up in young adult spina bifida subjects with myelomeningocele and to determine predictive factors for this follow-up.Material and methods: Between November 2003 and February 2004, a cross-sectional study was conducted in 131 patients aged over 18 years who had been regularly treated for myelomeningocele since their childhood in paediatric internal surgery. A questionnaire relating to most recent medical consultations, most recent upper urinary tract assessments (serum creatinine measurement and kidney ultrasound) and urine function was posted to each patient. Data from paediatric surgery hospital notes were collected.Results: The response rate was 62.6%. During the past two years, 43% of responders have had no specific urological follow-up, 46% have not had any serum creatinine measurements and 35% have not had any kidney ultrasound assessments. Patients who had urology consultations had more urinary tract infections than those who had no consultations (3.2 AE 3.5 vs 1.4 AE 1.9, P = 0.045, Student t test). Patients who had not consulted in urology had more urethral relaxation abnormalities (29.2 vs 13.1%, P = 0.026, Fisher exact test).Conclusion: Follow-up of young adults with spina bifida and myelomeningocele is insufficient. Patients consulting in urology have more urinary tract infections. Conversely, patients who do not consult in urology have more urethral relaxation abnormalities.

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Uroneurological assessment of spina bifida cystica and occulta

Cited by 61 publications

References 25 publications

Meningitis–retention syndrome

Meningitis–retention syndrome

Neurophysiologic Testing in Neurogenic Bladder Dysfunction: Practical or Academic?

Évaluation du suivi urologique à l’âge adulte des spina bifida avec une myéloméningocèle

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