Urological problems after surgical treatment of scoliosis in children with myelomeningocele.
OBJECTIVE
We assessed urological problems and complications after scoliosis surgery in children with myelomeningocele.


METHODS
A total of 16 children with myelodysplasia underwent surgery for scoliosis using different surgical techniques and instrumentation systems. Mean patient age at operation as 11 years and mean postoperative followup was 3 years. All patients had urological assessment before and after surgery, including urodynamics.


RESULTS
Urological problems after surgical correction of scoliosis developed in 6 patients (38%). Three girls had difficulty performing clean intermittent self-catheterization postoperatively because of altered body posture, a genital pressure sore and a plaster body cast, respectively. In 4 patients, including 1 girl with problems performing clean intermittent self-catheterization, lower urinary tract function was altered, leading to upper urinary tract deterioration in 1 and worsening of urinary incontinence in 3.


CONCLUSIONS
Children with myelomeningocele have a high incidence of urological complications after surgical treatment of scoliosis. Anticipation of the problems and a thorough postoperative urological evaluation, including urodynamics, can reduce morbidity and facilitate appropriate treatment.
Boemers
T M
TM
Department of Pediatric Urology, Wilhelmina Children's Hospital, University Hospital for Children, Utrecht, The Netherlands.
Soorani-Lunsing
I J
IJ
de Jong
T P
TP
Pruijs
H E
HE
D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008591:Meningomyelocele / Q000150:complications*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012600:Scoliosis / Q000209:etiology / Q000601:surgery*; D014570:Urologic Diseases / Q000453:epidemiology* / Q000209:etiology