title: Uronephrological outcomes of patients with neural tube defects. Does a spina bifida clinic make a difference?
abstract: OBJECTIVE
  To review the uronephrological outcomes of myelomeningocele (MMC) patients attending a Spina Bifida Clinic.
  
  
  METHODS
  We retrospectively reviewed the medical records of all patients from the combined Spina Bifida Clinic, at King Khalid University Hospital, Riyadh, Saudi Arabia between 1999 and 2009 who had at least one year of follow-up with us. We examined their demographic data, uronephrological status at presentation, most recent follow-up, and the rate of surgical intervention.
  
  
  RESULTS
  During the 10-year period, 188 patients were actively followed-up. The mean age at presentation was 5.3 years +/- 3.6 SD. At their last follow-up, 109 patients (58%) were using clean intermittent catheterization, 44 (23%) had received Botox injections, and 26 (14%) had undergone bladder reconstruction. Most (66%) patients were older than 3 years when they presented to us; this group had a significantly higher rate of surgical intervention (Botox or reconstruction) compared with those who came to us earlier (p=0.003 for patients receiving Botox injections, and p=0.025 for patients undergoing bladder reconstruction).
  
  
  CONCLUSIONS
  Our multidisciplinary Spina Bifida Clinic is an integral part of MCC management to reach a safe urological outcome. Early presentations to our clinic resulted in a lesser need for surgical intercession compared with those who presented at more than 3 years old.
authors.affiliation: Division of Urology, Department of Surgery (37), College of Medicine and King Khalid University Hospital, King Saud University, PO Box 7805, Riyadh 11472, Kingdom of Saudi Arabia. Tel. +966 (11) 4671836. E-mail: drhamdan@ksu.edu.sa.
authors.forename: Hamdan H
authors.initials: HH
authors.lastname: Al-Hazmi
authors.forename: Mahmoud S
authors.initials: MS
authors.lastname: Trbay
authors.forename: Abdulmonem B
authors.initials: AB
authors.lastname: Gomha
authors.forename: Ahmad A
authors.initials: AA
authors.lastname: Elderwy
authors.forename: Amenah J
authors.initials: AJ
authors.lastname: Khatab
authors.forename: Khalid F
authors.initials: KF
authors.lastname: Neel
mesh_terms: D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007674:Kidney Diseases / Q000209:etiology* / Q000628:therapy; D008297:Male; D008591:Meningomyelocele / Q000150:complications*; D009465:Neuromuscular Agents / Q000627:therapeutic use; D010044:Outpatient Clinics, Hospital; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D016135:Spinal Dysraphism / Q000150:complications*; D014570:Urologic Diseases / Q000209:etiology* / Q000628:therapy
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A