[Voiding problems and urinary tract complications in adolescents and adults with myelomeningocele].
BACKGROUND
The aim of this study was to describe voiding dysfunction and urinary tract complications in a population above 16 years of age with myelomeningocele.


METHODS
51 persons were included in the study. Data were obtained by questionnaires, ultrasound and glomerular filtration rate; in those with intact urinary bladder, by cystometry and videocystography.


RESULTS
30 out of 33 persons with intact urinary bladder were incontinent. Those with daily incontinence described this as a major problem. Cystometry concluded with normal detrusor contractions in three, detrusor hyperreflexia in five, and a detrusor hyporeflexia in 25 persons. Three out of 30 had vesicoureteral reflux. Ultrasound showed mild hydronephrosis and/or scarring in three persons. Average glomerular filtration rate was 86% (50-131%). 11 had Bricker diversion and seven continent reservoirs. 15 out of 18 persons with urinary diversion were satisfied with this solution. In persons with urinary diversion, the average glomerular filtration rate was 78% (44-109%). Ultrasound showed hydronephrosis and/or scarring in seven out of 16. Overall, urinary tract infections last year were reported by 56%, and pyelonephritis was more common in those with urinary diversion.


CONCLUSIONS
Incontinence is a common problem in adults with myelomeningocele. About one third had upper urinary tract changes, but none had renal failure.
Glott
T
T
Forskningsenheten, Sunnaas sykehus, 1450 Nesoddtangen. thomas.glott@sunnaas.no
Stanghelle
J K
JK
Rand-Hendriksen
S
S
Johnsen
V
V
Thyberg
M
M
Melhus
M
M
Brabrand
K
K
Fjeld
J G
JG
Bakke
A
A
D000293:Adolescent; D000328:Adult; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D007674:Kidney Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D008591:Meningomyelocele / Q000150:complications* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D014463:Ultrasonography; D001745:Urinary Bladder Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D014547:Urinary Diversion; D014549:Urinary Incontinence / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D016476:Urinary Reservoirs, Continent; D014718:Vesico-Ureteral Reflux / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology