title: The predictive factors of hydronephrosis in patients with spina bifida: reports from China.
abstract: OBJECTIVE
  To identify the risk factors for hydronephrosis in patients with neurogenic bladder caused by spina bifida.
  
  
  METHODS
  A retrospective analysis of 120 patients with hydronephrosis between January 2005 and 2012 was conducted. The patients were evaluated for the following factors: age, sex, voiding symptoms, experience of using clean intermittent catheterization, history of urinary tract infection (UTI), history of one or more tethered spinal cord release surgery, routine urine examination, serum creatinine, ultrasound for kidneys, ureters, bladder, and urodynamic findings by univariate and logistic regression analyses.
  
  
  RESULTS
  Among the 120 patients, 45 (38 %) had unilateral or bilateral hydronephrosis. Univariate analysis indicated that detrusor hyperreflexia, poor compliance (PC), vesicoureteral reflux (VUR), urinary incontinence, high residual urine, and UTI were the significant factors in the incidence of hydronephrosis. Multivariate analysis indicated that PC, VUR, and UTI were the risk factors for hydronephrosis and that detrusor hyperreflexia and urinary incontinence were the protective factors. UTI was the most serious risk factor for hydronephrosis, with an odds ratio of 29.6. Hydronephrosis was not associated with the history of tethered spinal cord release surgery.
  
  
  CONCLUSIONS
  This study revealed the prognostic risk factors for hydronephrosis. The medical history of patients, imaging examination, and urodynamic parameters play key roles in identifying the risk factors for hydronephrosis.
authors.affiliation: Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277, Jiefang Road, Wuhan, 430022, China. majunsheng82@163.com
authors.forename: Yan
authors.initials: Y
authors.lastname: Ma
authors.forename: Bing
authors.initials: B
authors.lastname: Li
authors.forename: Longwang
authors.initials: L
authors.lastname: Wang
authors.forename: Xiaomin
authors.initials: X
authors.lastname: Han
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D015994:Incidence; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016135:Spinal Dysraphism / Q000150:complications* / Q000453:epidemiology; D001750:Urinary Bladder, Neurogenic / Q000150:complications* / Q000453:epidemiology; D014549:Urinary Incontinence / Q000150:complications* / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000150:complications* / Q000453:epidemiology; D014563:Urodynamics; D014567:Urography; D014718:Vesico-Ureteral Reflux / Q000150:complications* / Q000453:epidemiology; D055815:Young Adult