The anocutaneous reflex and urinary continence in children with myelomeningocele.
OBJECTIVE
To examine the hypothesis that because most patients with myelomeningocele and a positive anocutaneous reflex have a competent sphincteric mechanism they are more likely to be continent on intermittent catheterization than those with a negative reflex, and to become so with less need for adjunctive surgical treatment.


METHODS
The study included 111 patients with myelomeningocele treated for urinary incontinence; their present means of treatment and the outcome achieved were assessed and related to the presence or absence of an anocutaneous reflex.


RESULTS
Among 29 patients with a positive anocutaneous reflex, 26 (90%) are currently dry on a regimen of intermittent catheterization, as opposed 41 (50%) of the 82 with a negative reflex (P < 0.001). Two (7%) of those with a positive and 23 (28%) of those with a negative reflex have undergone adjunctive surgery (P=0.024).


CONCLUSIONS
These findings are consistent with both aspects of the hypothesis detailed in the Objective.
Sanders
C
C
Department of Paediatric Urology, Alder Hey Children's Hospital, Eaton Road, Liverpool, L12 2AP, UK.
Driver
C P
CP
Rickwood
A M K
AM
D000293:Adolescent; D001003:Anal Canal / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008591:Meningomyelocele / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D012018:Reflex / Q000502:physiology; D012021:Reflex, Abnormal; D012879:Skin Physiological Phenomena; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery