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Volume 24 |
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Volume 24 |
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Number 5 |
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Urinary tract complications in patients
with spinal dysraphismsMostafa Sharifian1, Navid Anvaripour2, Alireza Zali3
ABSTRACT
Objective: To determine the prevalence of urinary complications and to review the management of these complications in patients with spinal dysraphism.
Methodology: This is a cross-sectional descriptive study in which Ninety four patients with various types of spinal dysraphism were studied. The mean age of patients was 7.2 years (range: 0.1-35 years), 56.4% were males. Sixty eight patients (72.3%) had at least one episode of pyelonephritis, hydronephrosis in 34.1%, vesicoureteral reflux in 35.1%, renal atrophy in 13.9% and end stage renal failure in 3.2% cases.
Results: Among 61 patients aged four years or older, forty seven (77%) had urinary incontinence. Seventy six cases (80.9%) had paraclinic findings in favour of neurogenic bladder. Of these, forty five (59.2%) received medical treatments (CIC ± anticholinergic agents). Anti-reflux surgery was performed in nine patients (9.6%); subsequently, vesicoureteral reflux relapsed in six cases.
Conclusion: Our study revealed that urinary complications were common in patients with spinal dysraphism. Early appropriate management based on urodynamic studies and careful follow-up of patients with spinal dysraphism will significantly decrease the occurrence of urinary complications in these children.
KEY WORDS: Spinal dysraphism, Neurogenic bladder, Urodynamic study, Vesicoureteral reflux, Urinary incontinence, Detrusor-sphincter dyssynergia.
Pak J Med Sci October - December 2008 (Part-I) Vol. 24 No. 5 729-734
How to cite this article:
Sharifian M, Anvaripour N, Zali A. Urinary tract complications in patients with spinal dysraphisms. Pak J Med Sci 2008;24(5):729-34.
1. Mostafa Sharifian,
Pediatric Infectious Research Center (PIRC),
2. Navid Anvaripour,
Department of Pediatrics,
3. Alireza Zali,
Department of Neurosurgery,
1-3: Mofid Children Hospital,
Shaheed Beheshti University of Medical Sciences,
Tehran, Iran
Correspondence
Mostafa Sharifian, MD
Pediatric Infectious Research Center (PIRC),
Shahid Behasti Uni. M.C.,
Mofid Children Hospital,
Shariati Ave, Tehran, Iran.
Email: mostafasharifian@yahoo.com
* Received for Publication: December 19, 2007
* Revision Accepted: July 1, 2008
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