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

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.

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.

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.

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.

Neurourology and urodynamics. 2018 Jul 30 [Epub]

Agnieszka Pastuszka, Janusz Bohosiewicz, Tomasz Koszutski

Chair and Department of Descriptive and Topographic Anatomy, School of Medicine with Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland., Higher School of Strategic Planning in Dąbrowa Górnicza, Śląski Uniwersytet Medyczny w Katowicach, Klinika Chirurgii i Urologii Dziecięcej, Katowice, Poland., Clinical Department of Children's Surgery, Department of Children's Surgery and Urology, School of Medicine in Katowice, Medical University of Silesia in Katowice, Katowice, Poland.