A 4-year prospective urological assessment of in utero Myelomeningocele repair: Does gestational age at birth play a role at later neurogenic bladder pattern?

A major complication of in utero myelomeningocele (MMC) repair is premature delivery. The prematurity rate in MOMS study was 79%, with a mean gestational age (GA) at birth of 34 weeks. Considering this particular aspect of prenatal surgery group, we speculated if prematurity could also influence the urological outcome.

Since November 2011, we prospectively followed a population of MMC patients that had undergone in utero repair.

We compared this population according to GA at birth: below 34 weeks (group 1) and 34 weeks or above (group 2). We studied 79 patients, 42 at group 1 and 37 at group 2. Mean GA at birth was 28.3 (25 -33) weeks in group 1 and 35.2 (34-38) weeks in group 2. Patients were classified as high risk in 47.5% of group 1 and 54.5% of group 2, incontinent in 35% of group 1 and 33.3% of group 2, hypocontractile in 10% of group 1 and normal pattern in 7.5% of group 1 and 12.1% of group 2, none with statistical significance. Mean follow up was 27.9 and 24.3 months for groups 1 and 2, respectively.

Our data showed that GA has little impact on bladder pattern. These data reinforce the need to follow these patients closely.

The Journal of urology. 2016 Dec 14 [Epub ahead of print]

Marcela Leal da Cruz, Riberto Liguori, Gilmar Garrone, Sérgio Leite Ottoni, Sérgio Cavalheiro, Antonio Fernandes Moron, Antonio Macedo

Department of Urology, NUPEP-CACAU, São Paulo, Brazil. Electronic address: ., Department of Urology, NUPEP-CACAU, São Paulo, Brazil., Department of Neurosurgery, Federal University of São Paulo, São Paulo, Brazil., Department of Obstetrics - Fetal Medicine, Federal University of São Paulo, Brazil; Santa Joana Maternity and Hospital, São Paulo, Brazil., Department of Urology, NUPEP-CACAU, São Paulo, Brazil; Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil.

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