Skip to main content

Occult spinal dysraphism: neurogenic voiding dysfunction and long-term urologic follow-up

Abstract

From 1976 to 1994, we followed 55 children with occult spinal dysraphism (OSD). The average age at diagnosis was 4.5 years (range: 24 days–21 years). In 13 cases the OSD was associated with anorectal anomalies. Urologic symptoms were present at diagnosis in 24 children (43%), but urinary incontinence affected all patients in the evolution of the OSD. At diagnosis, all children underwent complete neurourologic and urodynamic evaluation. Nine required early neurosurgical correction, before 3 years of age. During follow-up, intermittent clean catheterization was started in all patients. Vesicoureteral reflux was present or developed in 17 patients: 15 underwent endoscopic procedures and 2 required bladder augmentation because of upper-tract and renal-function deterioration. Endoscopic treatment for urinary incontinence was performed in 3 children. At long-term follow-up (6 to 18 years), socially acceptable continence was achieved in 78% of the children; renal failure occurred in 8. The long-term results were analyzed in order to compare the evolution of urinary continence and renal function in children with OSD with or without neurosurgery.

This is a preview of subscription content, access via your institution.

References

  1. Assaad A, Mousy A, Kotb M, Hafez M (1989) Spinal dysraphism: experience with 250 cases operated. Childs Nerv Syst 5: 324–329

    Google Scholar 

  2. Bauer SB, Hallet M, Khashbin S, Lebowitz RL, Winston KR, Gibson S, Colodny AH, Retik AB (1984) Predictive value of urodynamic evaluation in newborns with myelodysplasia. JAMA 252: 650–653

    Google Scholar 

  3. Boone D, Parsons D, Leachmann SM, Sherwood T (1985) Spina bifida occulta, lesion or anomaly? Clin Radiol 36: 159–165

    Google Scholar 

  4. Capozza N, De Gennaro M, Lais A (1987) Clean intermittent catheterization in management of children with myelodysplasia. Acta Med Rom 25: 336

    Google Scholar 

  5. Craigmaile TK (1977) Congenital anomalies of the spine. In: Ruge D, Wiltse L (eds) Spinal disorders: diagnosis and treatment. Lea and Febiger, Philadelphia, pp 223–245

    Google Scholar 

  6. De Gennaro M, Lais A, Caldarelli M (1990) Variability della situazione urodinamica nei bambini con mielomeningocele e suo eventuale rapporto con la tethered cord. Aula Med 3: 29

    Google Scholar 

  7. De Gennaro M, Lais A, Fariello G (1991) Early diagnosis and treatment of spinal dysraphism to prevent urinary incontinence. Eur Urol 929

  8. Fidas A, MacDonalds HL, Elken RA, Wild SR, Chilsom GD, Scott R (1987) Prevalence and patterns of spina bifida occulta in 2707 normal adults. Clin Radiol 38: 537–540

    Google Scholar 

  9. Geraniotis E, Koff SA, Enrile B (1988) The prophylactic use of clean intermittent catheterization in the treatment of infants and young children with myelomeningocele and neurogenic bladder dysfunction. J Urol 139: 85

    Google Scholar 

  10. Gross AJ, Michael T, Godmann F, Weigel K, Hulamd H (1993) Urological findings in patients with neurosurgically treated tethered spinal cord. J Urol 149: 1510–1511

    Google Scholar 

  11. Khoury AE, Hendrick EB, McLoire GA, Kulkarin A, Churchill BM (1990) Occult spinal dysraphism: clinical and urodynamic outcome after division of the filum terminale. J Urol 144: 426–429

    Google Scholar 

  12. McGuire EJ, Woodside JR, Borden TA, Weiss RM (1981) Prognostic value of urodynamic testing in myelodysplastic patients. J Urol 126: 205–210

    Google Scholar 

  13. O'Neil P, Singh J (1991) Occult spinal dysraphism in children: need for early neurosurgical referral. Childs Nerv Syst 7: 309–311

    Google Scholar 

  14. Yamada S, Knierim D, Yankura M, Schultz R, Maeda G (1983) Tethered cord syndrome. J Am Paraplegia Soc 6: 58–60

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Silveri, M., Capitanucci, M.L., Capozza, N. et al. Occult spinal dysraphism: neurogenic voiding dysfunction and long-term urologic follow-up. Pediatr Surg Int 12, 148–150 (1997). https://doi.org/10.1007/BF01349985

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01349985

Key words

  • Occult spinal dysraphism