[Factors of the urinary prognosis of myelomeningoceles].
Based on a retrospective series of 200 patients with myelomeningocele followed over a period of 3 to 17 years (mean = 9.02 years), the authors define the prognostic elements of the radiographic and urodynamic assessment. Their aim was to define a population at risk presenting a possibility of deterioration of the upper urinary tract. The mean age at the time of the first assessment by the authors was 12 years (range: 2 to 38 years), at which time the upper urinary tract was not dilated in 73% of cases and dilated in 27% of cases. Evaluation of the clinical course revealed that 7% of the upper tracts were dilated at the first consultation and only 1% of them remained so, 26% became dilated secondarily and 67% were never dilated throughout the observation period. The last cystometric assessment provided the following mean values: --for the overall population (200 patients): a premicturating pressure (P2) of 32 cm of water and a compliance (CPL) of 20 ml/cm of water; --for the population in which the upper tract was dilated at the last consultation (54 patients): a P2 of 45 cm of water and a CPL of 7 ml/cm of water; --for the population in which the upper tract was not dilated at the last consultation (146 patients): the P2 was 27 cm of water and the CPL was 24 ml/cm of water. These 2 parameters therefore appeared to be essential and their prognostic value should be evaluated.(ABSTRACT TRUNCATED AT 250 WORDS)
Bouchot
O
O
Clinique Urologique, CHR, Nantes.
Labat
J J
JJ
Glemain
P
P
Buzelin
J M
JM
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008591:Meningomyelocele / Q000150:complications* / Q000503:physiopathology; D011379:Prognosis; D012189:Retrospective Studies; D001743:Urinary Bladder / Q000503:physiopathology; D014563:Urodynamics; D014567:Urography; D014570:Urologic Diseases / Q000209:etiology* / Q000503:physiopathology
Les facteurs du pronostic urinaire des myélo-méningocèles.