Ces Urol 1999, 3(1):11-17

Treatment of lower urinary tract dysfunction in children with spinal dysraphism

Z. Dítě, J. Dvořáček, R. Kočvara, T. Hanuš

Katedra urologie IPVZ, Praha Urologická klinika 1. LF UK a VFN, Praha

The aim of this study was a retrospective analysis of treatment effectiveness of uro-logical complications in children with spinal dysraphism.
In years 1982 - 1996 we performed urodynamic exams in 45 children with spinal disraphism. Until today 32 patients remained in our care (20 boys and 12 girls). Children were classified following the results of urodynamics in two groups: In first group were 28 incontinent children (88 %) with maximal intravesical pressure (P ves.max.) of 40 cm H2O and higher, 11 children (40 %) from this group had signs of moderate or severe hydronephrosis and 5 boys (18 %) had signs of renal insufficiency. The second group consisted of four children (13 %) with maximum intravesical pressure under 40 cm H2O, two of them had signs of dilated upper urinary tract. None of them had signs of renal insufficiency.
Children were treated by intermittent cathetrisation (15), use of anticholinergics (25), baclophene (8), alfa-sympatolytics (4) and surgical intervention (18). Therapy effected the urodynamic parameters improvement in 24 kids (86 %), correction of hydronephrosis in 9 children (32 %) and withdrawl of renal insufficiency in 4 (14 %) and continence improvement in 20 patiens (89 %) from the first group. The urodynamic parameters and daily incontinence were improved in all 4 patients (100 %) from the second group. Hydronephrosis was repaired in 2 children (50 %).

Keywords: Spinal dysraphism, Urodynamic examination, Anticholinergics

Published: January 1, 1999