title: Urodynamic score in children with lipomyelomeningocele: a prospective study.
abstract: OBJECTIVE
  We assessed the correlation between urodynamic score and presence of symptoms in children with lipomyelomeningocele, and the usefulness of this measure in monitoring these children.
  
  
  METHODS
  We prospectively evaluated 29 patients 1 month to 13 years old (mean 1.9 years) with lipomyelomeningocele from 1995 to 2010. A 4-parameter urodynamic score ranging from 0 to 17 was assigned to each patient at diagnosis and followup. Indications for surgery were presence of symptoms and signs or abnormal urodynamic score. Children were divided into 2 groups, symptomatic and asymptomatic. The latter group was further divided into operated and conservatively managed cases. Average followup was 6.7 years (range 2 to 16).
  
  
  RESULTS
  The symptomatic group contained 11 children (38%) operated on at a mean age of 2.9 years. Mean followup was 6.7 years (range 2 to 12). All patients presented with an abnormal urodynamic score. Postoperative urodynamic score improved in 6 patients (55%), remained abnormal in 4 (36%) and deteriorated in 1 (9%). The asymptomatic group contained 18 patients, of whom 7 (39%) were operated on at a mean age of 1.4 years. Mean followup was 10 years (range 3 to 16). Postoperative score improved in 6 patients (86%) and remained unchanged in 1 (14%). A total of 11 cases (61%) were managed conservatively, with a mean followup 4.3 years (range 2 to 7). Of these patients 3 (27%) presented with late urodynamic score deterioration at 3, 5 and 6 years of followup while remaining asymptomatic.
  
  
  CONCLUSIONS
  Urodynamic score is a useful tool in monitoring children with lipomyelomeningocele because it has a good correlation with the presence of symptoms.
authors.affiliation: Department of Pediatric Surgery, Centre Hospitalier Universitaire Vaudois-CHUV, Lausanne, Switzerland.
authors.forename: Gëzim
authors.initials: G
authors.lastname: Dushi
authors.forename: Peter
authors.initials: P
authors.lastname: Frey
authors.forename: Pascal
authors.initials: P
authors.lastname: Ramseyer
authors.forename: Olivier
authors.initials: O
authors.lastname: Vernet
authors.forename: Blaise J
authors.initials: BJ
authors.lastname: Meyrat
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008591:Meningomyelocele / Q000175:diagnosis* / Q000503:physiopathology*; D011446:Prospective Studies; D014563:Urodynamics