Bladder and bowel function in children with congenital spinal lipomatus malformations. A retrospective study in 114 cases - Abstract

OBJECTIVE:To clarify bladder and bowel function of children with lipomas of the conus, without, before and after neurosurgery.

PATIENTS AND METHODS: Retrospective analysis of 114 children with a lipomas of the conus, followed in our pediatric neuro-urology department from 1993 to 2010. Several data were collected: bladder and bowel symptoms, bladder and anorectal continence, neurosurgical indication and age, clinical modification after neurosurgery, investigations carried out in pre- and post-surgery treatment, associated bladder and bowel treatment.

RESULTS: Forty-nine of the 77 children (63.6%) operated on had never been seen before surgery in our neuro-urology department. Seventy-seven children (67.5%) underwent a neuro-surgery, 60% indicated due to a neurogenic bladder. Before neurosurgery, 66 children (85.7%) had spontaneous miction. Five children (6.5%) had bladder intermittent catheterization. Forty of these patients (56.3%) were continent. After neurosurgery and a specialized consultation in neuro-urology, 54 children (70.1%) were continent. Thirty-seven children (48%) had spontaneous miction. Thirty-seven children (48%) had bladder intermittent catheterization and drug of overactive detrusor. Fifty-two children (67.5%) were constipated after surgery. Seventy-seven percent of the treatments for bowel symptoms were effective in terms of continence.

CONCLUSION: The existence of a neurogenic bladder was one of the main indications for neurosurgery. These results suggest that the complexity of care requires neurosurgical, urological surgeon and neuro-urology physician to achieve the explorations and urinary and digestive treatment in order to preserve renal function and both continences.

Written by:
Guinet A, Audry G, Zerah M, Forin V. Are you the author?
Unité pédiatrique de médecine physique et de réadaptation, université Pierre-et-Marie-Curie, hôpitaux universitaires Paris Est Trousseau-La Roche-Guyon, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France.

Reference: Prog Urol. 2012 May;22(5):291-300.
doi: 10.1016/j.purol.2011.12.001

PubMed Abstract
PMID: 22515926

Article in French. Pediatric Urology Section