title: Urinary continence across the life course.
abstract: Spina bifida is the most common defect of the central nervous system. It is a congenital malformation of the spine with abnormal neural tube closure occurring between the third and fourth weeks of gestation, and most frequently affecting the lumbar and sacral regions. Most children with spina bifida have a normal urinary tract at birth, although renal damage and renal failure are among the most severe complications of spina bifida. Before ventricular shunting, survival rates for children with spina bifida were low, but most patients can now be expected to live into adulthood, thus prevention of urologic complications and promotion of continence have become critical. This article reviews the literature regarding urinary continence, and discusses issues across the lifespan, and implications for clinical practice and the pediatrician's role in the urologic care of children with spina bifida.
authors.affiliation: Department of Pediatrics, University of Southern California, University Center for Excellence in Developmental Disabilities, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Los Angeles, CA 90027, USA. kasmith@chla.usc.edu
authors.forename: Kathryn
authors.initials: K
authors.lastname: Smith
authors.forename: Stacey
authors.initials: S
authors.lastname: Mizokawa
authors.forename: Ann
authors.initials: A
authors.lastname: Neville-Jan
authors.forename: Kristy
authors.initials: K
authors.lastname: Macias
mesh_terms: D003695:Delivery of Health Care / Q000379:methods*; D006801:Humans; D011788:Quality of Life; D016135:Spinal Dysraphism / Q000150:complications*; D014481:United States; D014549:Urinary Incontinence / Q000209:etiology* / Q000503:physiopathology; D014563:Urodynamics / Q000502:physiology*; D014572:Urology / Q000379:methods*