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Urinary tract complications of myelomeningocele (spina bifida)

Authors
Laurence S Baskin, MD, FAAP
Angelique Champeau, CPNP
Section Editors
Marc C Patterson, MD, FRACP
Leonard E Weisman, MD
Duncan Wilcox, MD
Deputy Editor
Carrie Armsby, MD, MPH

INTRODUCTION

Nearly all patients with myelomeningocele have bladder dysfunction (neurogenic bladder). This may adversely affect urinary continence and quality of life, and can also lead to progressive deterioration of the upper urinary tract and chronic renal disease. Thirty to 40 percent of children with myelomeningocele develop some degree of renal dysfunction [1]. Treatment to reduce bladder pressures and minimize urine stasis often prevents or attenuates this complication.

The assessment and management of the urinary tract complications of spina bifida are discussed here. Other aspects of myelomeningocele are discussed separately. (See "Pathophysiology and clinical manifestations of myelomeningocele (spina bifida)" and "Overview of the management of myelomeningocele (spina bifida)".)

PATHOPHYSIOLOGY

Patients with myelomeningocele have problems with storage and/or emptying of urine because the spinal cord lesion disrupts central nervous system control of urinary voiding mechanisms. The abnormalities of lower urinary tract dynamics include:

Flaccid bladder

High pressure bladder

                         

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Literature review current through: Nov 2016. | This topic last updated: Mon Dec 05 00:00:00 GMT 2016.
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