Urinary Tract Complications in 94 Patients with Spinal Dysraphisms

Objective: To determine the prevalence of urinary complications and to review the management of these complications in patients with spinal dysraphism. Methodology: This is a cross-sectional descriptive study in which Ninety four patients with various types of spinal dysraphism were studied. The mean age of patients was 7.2 years (range: 0.1-35 years), 56.4% were males. Sixty eight patients (72.3%) had at least one episode of pyelonephritis, hydronephrosis in 34.1%, vesicoureteral reflux in 35.1%, renal atrophy in 13.9% and end stage renal failure in 3.2% cases. Results: Among 61 patients aged four years or older, forty seven (77%) had urinary incontinence. Seventy six cases (80.9%) had paraclinic findings in favour of neurogenic bladder. Of these, forty five (59.2%) received medical treatments (CIC ± anticholinergic agents). Anti-reflux surgery was performed in nine patients (9.6%); subsequently, vesicoureteral reflux relapsed in six cases. Conclusion: Our study revealed that urinary complications were common in patients with spinal dysraphism. Early appropriate management based on urodynamic studies and careful follow-up of patients with spinal dysraphism will significantly decrease the occurrence of urinary complications in these children.