474 / 492
13:36 - 13:42
ICCS S5-4
(LO)
PREOPERATIVE AND POSTOPERATIVE URODYNAMIC DIFFERENCES OF CHILDREN
WITH SPINA BIFIDA APERTA
S. Kerem OZEL
1
, Ibrahim ALATAS
2
, Ezgi Tuna ERDOGAN
3
, Tuba TUNC
4
, Altan ALIM
1
, Nursu KARA
5
and Huseyin CANAZ
2
1) Istanbul Bilim University Spina Bifida Research Center, Paediatric Urology, Istanbul, TURKEY - 2) Istanbul Bilim
University Spina Bifida Research Center, Paediatric Neurosurgery, Istanbul, TURKEY - 3) Istanbul Bilim University Spina
Bifida Research Center, Neurophysiology, Istanbul, TURKEY - 4) Darica State Hospital, Neonatology, Izmit, TURKEY - 5)
Istanbul Bilim University Spina Bifida Research Center, Neonatology, Istanbul, TURKEY
PURPOSE
Neurological injury starts from antenatal period in spina bifida. After postnatal repair, patients are followed up
neurourologically. The aim of this retrospective study was to compare the preoperative and postoperative urodynamic
results to predict the outcome in these patients.
MATERIAL AND METHODS
The urodynamic reports of patients with the diagnosis of spina bifida aperta (SBA) were evaluated. Only the reports
before the closure of the defect were included in the study. The postoperative patients were randomly selected and their
urodynamic results were noted. Age, sex, postvoid residual urine, leak point pressures, capacity, compliance, detrusor
and sphincter activities were noted. One way ANOVA test for comparison of numeric values and chi-square test for
nominal values were used.
RESULTS
Among a total of 780 patients, 24 newborns with SBA and 50 postoperative cases were selected, randomly. Preoperative
evaluation was done at a mean age of 2,4±3,4 days. The measured bladder capacity was significantly assessed as
low in newborn SBA patients (p=0,015). The bladder compliance was found to be significantly lower in postoperative
group (15,7±25,6 months of age) (p=0,05). Detrusor overactivity is marked in preoperative group (p=0,036) but
sphincter dyssynergia was equally common in both groups. There was no significant difference in terms of postvoid
residual urine and leak point pressures in both groups.
CONCLUSIONS
Neuropathic bladder dysfunction is a congenital injury in SBA patients. Preoperatively the patients are born more prone
to detrusor overactivity and decreased capacity. This overactivity and bladder compliance decreases with age. The
delineation of the course of the disease may give the opportunity for proper neurourological follow up.