title: Preoperative assessment of neurovesical function in children with anorectal malformation: association with vertebral and spinal malformations.
abstract: OBJECTIVE
  We preoperatively assessed neurovesical function and spinal cord function in children with anorectal malformations. In cases of neurovesical dysfunction we looked for an association with vertebral malformation or myelodysplasia.
  
  
  METHODS
  We prospectively evaluated 80 children with anorectal malformations via preoperative urodynamics and magnetic resonance imaging of the spine. Bladder compliance and volume, detrusor activity and vesicosphincteric synergy during voiding allowed urodynamic evaluation. Results were reported according to Wingspread and Krickenbeck classifications of anorectal malformations.
  
  
  RESULTS
  Urodynamic findings were pathological in 14 children (18%). Pathological evaluations did not seem related to type of fistula or level of anorectal malformation. Vertebral anomalies were seen in 34 patients (43%) and myelodysplasia in 16 (20%). Neither vertebral anomaly nor myelodysplasia seemed associated with type of fistula or severity of anorectal malformation. Of 14 children with pathological urodynamics no vertebral anomaly or myelodysplasia was found in 7. Of 66 children with normal urodynamics 40 presented with vertebral or spinal malformation.
  
  
  CONCLUSIONS
  Lower urinary tract dysfunction is common in patients with anorectal malformations. Normal spine or spinal cord does not exclude neurovesical dysfunction. Myelodysplasia or vertebral anomaly does not determine lower urinary tract dysfunction. Thus, we recommend preoperative urodynamic assessment of the bladder and magnetic resonance imaging of the spine in children with anorectal malformations.
authors: Department of Pediatric Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors: E
authors: E
authors: Stathopoulos
authors: V
authors: V
authors: Muehlethaler
authors: M
authors: M
authors: Rais
authors: L
authors: L
authors: Alamo
authors: G
authors: G
authors: Dushi
authors: P
authors: P
authors: Frey
authors: P
authors: P
authors: Ramseyer
authors: B J
authors: BJ
authors: Meyrat
mesh_terms: D000015:Abnormalities, Multiple / Q000503:physiopathology*; D001003:Anal Canal / Q000002:abnormalities*; D001006:Anus, Imperforate / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009436:Neural Tube Defects / Q000150:complications / Q000503:physiopathology*; D011300:Preoperative Care; D011446:Prospective Studies; D012007:Rectum / Q000002:abnormalities*; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000503:physiopathology*; D014563:Urodynamics