Prenatal myelomeningocele repair improves urinary continence and reduces the risk of constipation

• Published in: Neurourology and urodynamics Vol. 37; no. 8; pp. 2792 - 2798
• Main Authors: Pastuszka, Agnieszka, Bohosiewicz, Janusz, Koszutski, Tomasz
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.11.2018
• Subjects: Children; Constipation; melomeningocele; neurogenic bladder and bowel; Patients; prenatal surgery; Statistical analysis; Surgery; Urinary tract; Urinary tract infections; Urine; Urogenital system; melomeningocele; prenatal surgery; neurogenic bladder and bowel
• ISSN: 0733-2467; 1520-6777
• DOI: 10.1002/nau.23771

Aims The aim of the study was to evaluate the lower urinary tract function, frequency UTI, the degree of social urine continence, and the occurrence of constipation in children who underwent prenatal or postnatal surgery for MMC. Materials and Methods Seventy‐two patients with MMC were assessed and divided into the prenatal group (36 patients) and the postnatal one (36 patients). All children, regardless the time of operation, received the same treatment after birth. The urodynamic tests, USG, cystourethrography were performed in all patients along with evaluation of the UTI's, social urine continence, and presence of constipation. Results Urodynamic and imaging studies showed no differences between the test groups. Children from the prenatally operated group showed statistically significant lower number of urinary tract infections, better urine continence, and less frequent constipation. Conclusions Prenatal MMC repair ensures statistically significant improvement of the degree of social urinary continence, reducing the risk of urinary infections and constipation. Time of MMC repair does not statistically influence the urodynamic tests results and the urodynamic parameters are not the prognostic elements to assess the social urinary continence possibility in patients with the neurogenic bladder.