Changes in urodynamics after repair surgery in children with dominant spina bifida

WANG Ping; XIE Xiang-hui; ZHANG Wei-ping; SUN Ning; LI ming-lei; SONG Hong-cheng; JIAO Li-li

doi:10.13798/j.issn.1009-153X.2019.08.006

Abstract：Objective To analyze the changes in the clinical symptoms and urodynamics after the surgery in the children with dominant spina bifida in order to determine whether there is a correlation between the surgery and change in the lower urinary tract function. Methods The clinical data of 26 children with dominant spina bifida, of whom, 12 suffered from lipomyelomeningocele, 10 from myelomeningocele and 4 from meningocele, were analyzed retrospectively, including the clinical manifestations and outcomes of urodynamic examination before and after the surgery and so on. The repair surgery was performed in all the children in n our department from June, 2016 to December, 2018. Results There were lower urinary tract symptoms in 8 children, but no hydronephrosis was found in all the children before the operation. There were the lowe rurinary tract symptoms in 9 children and there was hydronephrosis in 2 children after the operation. The maximum bladder volume was significantly increased after the operation compared with before the operation (P<0.05). However, there were insignificant differences in the bladder compliance, residual urine volume, and detrusor sphincter dysfunction and detrusor pressure at the maximum urine flow rate between before and after the operation (P>0.05). Conclusions The abnormal bladder emptying and lower bladder compliance are the most common changes in the urinary dynamics before the repair surgery in the children with dominant spina bifida. There was no significant improvement in the lower urinary tract dysfunction and short-term clinical manifestation after the operation compared with before the operation.