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Spina Bifida

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Urological Emergencies

Part of the book series: Current Clinical Urology ((CCU))

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Abstract

Abnormal development of the spinal canal and cord is the most common cause of neurogenic bladder dysfunction in children. Spina bifida, also known as myelodysplasia, is a general term that describes various abnormal conditions affecting spinal cord function. Meningocele occurs when the meninges without neural elements extend beyond the vertebral canal. When the meninges are accompanied by neural elements, a myelomeningocele results. Lipomyelomeningocele occurs when fatty tissue has developed within the cord structures, and all elements evaginate beyond the vertebral canal.

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References

  1. Stein SC, Feldman JG, Friedlander M, Klein RJ, Is myelomeningocele a disappearing disease? Pediatrics 1982; 69: 511–514.

    PubMed  CAS  Google Scholar 

  2. Sutherland RS, Mevorach RA, Baskin LS, Kogan B A. Spinal dysraphism in children: an overview and an approach to prevent complications. Urology 1995; 46: 294–304.

    Article  PubMed  CAS  Google Scholar 

  3. Czeizel AE, Dudas I. Prevention of the first occurrence of neural-tube defects by periconceplional vitamin supplementation. N Engl J Med 1992; 327: 1832–1835.

    Article  PubMed  CAS  Google Scholar 

  4. Scarff TB, Fronczak S. Myelomeningocele: a review and update. Rehabil Lit 1981; 42: 143–146,192.

    PubMed  CAS  Google Scholar 

  5. Stark GD. Spina Bifida: Problems and Management. Blackwell Scientific, Oxford, UK, 1977.

    Google Scholar 

  6. Bauer SB, Labib KB, Dieppa RA, Retik AB. Urodynamic evaluation of boy with myelodysplasia and incontinence. Urology, 1977; 10: 354–362.

    Article  PubMed  CAS  Google Scholar 

  7. Pontari MA, Keating M, Kelly M, Dyro F, Bauer SB. Retained sacral function in children with high level myelodysplasia. J Urol 1995; 154: 775–777.

    Article  PubMed  CAS  Google Scholar 

  8. Selzman AA, Elder JS, Mapstone TB. Urologic consequences of myelodysplasia and other congenital abnormalities of the spinal cord. Urol Clin North Am 1993; 20: 485–504.

    PubMed  CAS  Google Scholar 

  9. Kraus SR, Boone TB. Pediatric neurogenic bladder: etiology and diagnostic evaluation. In: Pediatric Urology Practice. (Gonzales ET, Bauer SB, eds.), Lippincott, Williams, and Wilkins, Philadelphia, PA, 1999, pp. 365–381.

    Google Scholar 

  10. Luthy DA, Wardinsky T, Shurtleff DB, et al. Cesarean section before the onset of labor and subsequent motor function in infants with meningomyelocele diagnosed antenatally. N Engl J Med 1991; 324: 662–666.

    Article  PubMed  CAS  Google Scholar 

  11. Adzick NS, Sutton LN, Crombleholme TM, Flake AW. Successful fetal surgery for spina bifida. Lancet 1993; 352: 1675–1676.

    Article  Google Scholar 

  12. Holmes NM, Nguyen FIT, Harrison MR, Farmer DL, Baskin LS. Fetal intervention for myelomeningocele: effect on postnatal bladder function. J Urol 2001; 166: 2383–2386.

    Article  PubMed  CAS  Google Scholar 

  13. Kroovand RL, Bell W, Hart LJ, Benfield KY. The effect of back closure on detrusor function in neonates with myelomeningocele. J Urol 1990; 144: 423–424.

    PubMed  CAS  Google Scholar 

  14. Bauer SB. The management of spina bifida from birth onwards. In: Paediatric Urology. (Whitaker RH, Woodard JR, eds.), Butterworths, London, UK, 1985, pp. 87–112.

    Google Scholar 

  15. McGuire EJ, Woodside JR, Borden TA, Weiss RM. Prognostic value of urodynamic testing in myelodysplastic patients. 1981. J Urol 2002; 167: 1049–1053.

    Article  PubMed  Google Scholar 

  16. Lais A, Kasabian NG, Dyro FM, Scott RM, Kelly MD, Bauer SB. The neurosurgical implications of continuous neurourological surveillance of children with myelodysplasia. J Urol 1993; 150: 1879–1883.

    PubMed  CAS  Google Scholar 

  17. Joseph DB, Bauer SB, Colodny AH, Mandell J, Retik AB. Clean, intermittent catheterization of infants with neurogenic bladder. Pediatrics 1989; 84: 78–82.

    PubMed  CAS  Google Scholar 

  18. Chiaramonte RM, Horowitz EM, Kaplan GW, Brock WA. Implications of hydronephrosis in the newborn with myelodysplasia. J Urol 1986; 136: 427–429.

    PubMed  CAS  Google Scholar 

  19. Bauer SB, Hallett M, Khoshbin S, et al. Predictive value of urodynamic evaluation in newborns with myelodysplasia. JAMA 1984; 252: 650–652.

    Article  PubMed  CAS  Google Scholar 

  20. Wu HY, Baskin LS, Kogan BA. Neurogenic bladder dysfunction due to myelomeningocele: neonatal vs childhood treatment. J Urol 1997; 157: 2295–2297.

    Article  PubMed  CAS  Google Scholar 

  21. Sidi AA, Aliabadi II, Gonzalez R. Enterocystoplasty in the management and reconstruction of the pediatric neurogenic bladder. J Pediatr Surg 1987; 22: 153–157.

    Article  PubMed  CAS  Google Scholar 

  22. Bauer SB, Koff SA, Jayanthi VR. Voiding dysfunction in children: neurogenic and non-neurogenic. In: Campbell’s Urology. (Walsh P, Retik AB, Wein A, eds.), Saunders, Philadelphia, PA, 2002, pp.2231–2260.

    Google Scholar 

  23. McGuire EJ, Woodside JR, Borden TA, Weiss RM. Prognostic value of urodynamic testing in myelodysplastic patients. J Urol 1981; 126: 205–209.

    PubMed  CAS  Google Scholar 

  24. Blaivas JG, Labib KL, Bauer SB, Retik AB. Changing concepts in the urodynamic evaluation of children. J Urol 1977; 117: 778–781.

    PubMed  CAS  Google Scholar 

  25. Geraniotis E, Koff S A, Enrile B. The prophylactic use of clean intermittent catheterization in the treatment of infants and young children with myelomeningocele and neurogenic bladder dysfunction. J Urol 1988; 139: 85–86.

    PubMed  CAS  Google Scholar 

  26. Edelstein RA, Bauer SB, Kelly MD, et al. The long-term urological response of neonates with myelodysplasia treated proactively with intermittent catheterization and anticholinergic therapy. J Urol 1995; 154: 1500–1504.

    Article  PubMed  CAS  Google Scholar 

  27. Mandell J, Bauer SB, Colodny AH, Retik AB. Cutaneous vesicostomy in infancy. J Urol 1981; 126: 92–93.

    PubMed  CAS  Google Scholar 

  28. Lindehall B, Moller A, Hjalmas K, Jodal U. Long-term intermittent catheterization: the experience of teenagers and young adults with myelomeningocele. J Urol 1994; 152: 187–189.

    PubMed  CAS  Google Scholar 

  29. Park JM, Bauer SB, Freeman MR, Peters CA. Oxybutynin chloride inhibits proliferation and suppresses gene expression in bladder smooth muscle cells. J Urol 1999; 162: 1110–1114.

    Article  PubMed  CAS  Google Scholar 

  30. Spindel MR, Bauer SB, Dyro FM, et al. The changing neurourologic lesion in myelodysplasia. JAMA 1987; 258: 1630–1633.

    Article  PubMed  CAS  Google Scholar 

  31. Begeer JH, Meihuizen de Regt MJ, HogenEsch I, Ter Weenie CA, Mooij JJ, Vencken LM. Progressive neurological deficit in children with spina bifida aperta. Z Kinderchir 1986; 41: 13–15.

    PubMed  Google Scholar 

  32. Flood HD, Ritchey ML, Bloom DA, Huang C, McGuire EJ. Outcome of reflux in children with myelodysplasia managed by bladder pressure monitoring. J Urol 1994; 152: 1574–1577.

    PubMed  CAS  Google Scholar 

  33. Jeffs RD, Jonas P, Schillinger JF. Surgical correction of vesicoureteral reflux in children with neurogenic bladder. J Urol 1976; 115: 449–151.

    PubMed  CAS  Google Scholar 

  34. Joyner BD, McLorie GA, Khoury AE. Sexuality and reproductive issues in children with myelomeningocele. Eur J Pediatr Surg 1998; 8: 29–34.

    Article  PubMed  CAS  Google Scholar 

  35. Coakley RM, Holmbeck GN, Friedman D, Greenley RN, Thill AW. A longitudinal study of pubertal timing, parent-child conflict, and cohesion in families of young adolescents with spina bifida. J Pediatr Psychol 2002; 27: 461–473.

    Article  PubMed  Google Scholar 

  36. Decter RM, Furness PD 3rd, Nguyen TA, McGowan M, Laudermilch C, Telenko A. Reproductive understanding, sexual functioning and testosterone levels in men with spina bifida. J Urol 1997; 157: 1466–1468.

    Article  PubMed  CAS  Google Scholar 

  37. Sandler AD, Worley G, Leroy EC, Stanley SD, Kalman S. Sexual function and erection capability among young men with spina bifida. Dev Med Child Neurol 1996; 38: 823–829.

    Article  PubMed  CAS  Google Scholar 

  38. Woodhouse CR. The sexual and reproductive consequences of congenital genitourinary anomalies. J Urol 1994; 152: 645–651.

    PubMed  CAS  Google Scholar 

  39. Bomalaski MD, Teague JL, Brooks B. The long-term impact of urological management on the quality of life of children with spina bifida. J Urol 1995; 154: 778–781.

    Article  PubMed  CAS  Google Scholar 

  40. Koch MO, McDougal WS. The pathophysiology of hyperchloremic metabolic acidosis after urinary diversion through intestinal segments. Surgery 1985; 98: 561–570.

    PubMed  CAS  Google Scholar 

  41. Gosalbez R Jr, Woodard JR, Broecker BH, Warshaw B. Metabolic complications of the use of stomach for urinary reconstruction. J Urol 1993; 150: 710–712.

    PubMed  Google Scholar 

  42. Adams MC, Bihrle R, Rink RC. The use of stomach in urologic reconstruction. Am Urol Assoc Update Series 1995; 122.

    Google Scholar 

  43. Schlager TA, Dilks S, Trudell J, Whittam TS, Hendley JO. Bacteriuria in children with neurogenic bladder treated with intermittent catheterization: natural history. J Pediatr 1995; 126: 490–496.

    Article  PubMed  CAS  Google Scholar 

  44. Bakke A, Digranes A, Hoisaeter PA. Physical predictors of infection in patients treated with clean intermittent catheterization: a prospective 7-year study. Br J Urol 1997; 79: 85–90.

    PubMed  CAS  Google Scholar 

  45. Zhanel GG, Harding GK, Guay DR. Asymptomatic bacteriuria. Which patients should be treated? Arch Intern Med 1990; 150: 1389–1396.

    Article  PubMed  CAS  Google Scholar 

  46. Kaefer M, Tobin MS, Hendren WII, et al. Continent urinary diversion: the Children’s Hospital experience. J Urol 1997; 157: 1394–1399.

    Article  PubMed  CAS  Google Scholar 

  47. Barroso U, Jednak R, Fleming P, Barthold JS, Gonzalez R. Bladder calculi in children who perform clean intermittent catheterization. BJU Int 2000, 85: 879–884.

    Article  PubMed  CAS  Google Scholar 

  48. Palmer LS, Franco I, Kogan SJ, Reda E, Gill B, Levitt SB. Urolithiasis in children following augmentation cysloplasty. J Urol 1993; 150: 726–729.

    PubMed  CAS  Google Scholar 

  49. Kronner KM, Casale AJ, Cain MP, Zerin MJ, Keating MA, Rink RC. Bladder calculi in the pediatric augmented bladder. J Urol 1998; 160: 1096–1098.

    Article  PubMed  CAS  Google Scholar 

  50. Kaefer M, Hendren WH, Bauer S B, et al. Reservoir calculi: a comparison of reservoirs constructed from stomach and other enteric segments. J Urol 1998; 160: 2187.

    Article  PubMed  CAS  Google Scholar 

  51. Cain MP, Casale AJ, Kaefer M, Yerkes E, Rink RC. Percutaneous cystolithotomy in the pediatric augmented bladder. J Urol 2002; 168: 1881–1882.

    Article  PubMed  Google Scholar 

  52. Pope JO, Rink RC. Surgical options in the management of the neurogenic bladder. In: Pediatric Urology Practice. (Gonzales ET, Bauer SB, eds.), Lippincott, Williams, and Wilkins, Philadelphia, PA, 1999, pp. 401–419.

    Google Scholar 

  53. Bauer SB, Hendren WH, Kozakewich H, et al. Perforation of the augmented bladder. J Urol 1992; 148: 699–703.

    PubMed  CAS  Google Scholar 

  54. Worley G, Wiener JS, George T.M, et al. Acute abdominal symptoms and signs in children and young adults with spina bifida: 10 years’ experience. J Pediatr Surg 2001; 36: 1381–1386.

    Article  PubMed  CAS  Google Scholar 

  55. Braverman RM, Lebowitz RL. Perforation of the augmented urinary bladder in nine children and adolescents: importance of cystography. AJR Am J Roentgenol 1991; 157: 1059–1063.

    PubMed  CAS  Google Scholar 

  56. Rushton HG, Woodard JR, Parrott TS, Jeffs RD, Gearhart JP. Delayed bladder rupture after augmentation enterocystoplasty. J Urol 1988; 140: 344–346.

    PubMed  CAS  Google Scholar 

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© 2005 Humana Press Inc., Totowa, NJ

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Nguyen, H.T. (2005). Spina Bifida. In: Wessells, H., McAninch, J.W. (eds) Urological Emergencies. Current Clinical Urology. Humana Press. https://doi.org/10.1385/1-59259-886-2:363

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  • DOI: https://doi.org/10.1385/1-59259-886-2:363

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-256-8

  • Online ISBN: 978-1-59259-886-1

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