Department of Pediatric Surgery, Centre Hospitalier Universitaire Vaudois-CHUV, Lausanne, Switzerland.
J Urol. 2011 Aug;186(2):655-9. doi: 10.1016/j.juro.2011.03.157. Epub 2011 Jun 17.
We assessed the correlation between urodynamic score and presence of symptoms in children with lipomyelomeningocele, and the usefulness of this measure in monitoring these children.
We prospectively evaluated 29 patients 1 month to 13 years old (mean 1.9 years) with lipomyelomeningocele from 1995 to 2010. A 4-parameter urodynamic score ranging from 0 to 17 was assigned to each patient at diagnosis and followup. Indications for surgery were presence of symptoms and signs or abnormal urodynamic score. Children were divided into 2 groups, symptomatic and asymptomatic. The latter group was further divided into operated and conservatively managed cases. Average followup was 6.7 years (range 2 to 16).
The symptomatic group contained 11 children (38%) operated on at a mean age of 2.9 years. Mean followup was 6.7 years (range 2 to 12). All patients presented with an abnormal urodynamic score. Postoperative urodynamic score improved in 6 patients (55%), remained abnormal in 4 (36%) and deteriorated in 1 (9%). The asymptomatic group contained 18 patients, of whom 7 (39%) were operated on at a mean age of 1.4 years. Mean followup was 10 years (range 3 to 16). Postoperative score improved in 6 patients (86%) and remained unchanged in 1 (14%). A total of 11 cases (61%) were managed conservatively, with a mean followup 4.3 years (range 2 to 7). Of these patients 3 (27%) presented with late urodynamic score deterioration at 3, 5 and 6 years of followup while remaining asymptomatic.
Urodynamic score is a useful tool in monitoring children with lipomyelomeningocele because it has a good correlation with the presence of symptoms.
我们评估了尿动力学评分与脂肪脊膜脊髓膨出患儿症状之间的相关性，以及该方法在监测这些患儿中的作用。
我们前瞻性评估了 1995 年至 2010 年间 29 例年龄 1 个月至 13 岁（平均 1.9 岁）的脂肪脊膜脊髓膨出患儿。在诊断和随访时，每位患儿均获得 0 至 17 分的 4 项参数尿动力学评分。手术指征为存在症状和体征或异常尿动力学评分。患儿分为有症状和无症状两组。无症状组再分为手术和保守治疗两组。平均随访 6.7 年（范围 2 至 16 年）。
有症状组 11 例患儿（38%）于平均 2.9 岁时手术，平均随访 6.7 年（范围 2 至 12 年）。所有患儿的尿动力学评分均异常。术后 6 例（55%）患儿的尿动力学评分改善，4 例（36%）仍异常，1 例（9%）恶化。无症状组 18 例患儿中，7 例（39%）于平均 1.4 岁时手术，平均随访 10 年（范围 3 至 16 年）。术后 6 例（86%）患儿的评分改善，1 例（14%）不变。共 11 例（61%）患儿行保守治疗，平均随访 4.3 年（范围 2 至 7 年）。其中 3 例（27%）患儿在 3、5 和 6 年随访时出现迟发性尿动力学评分恶化，且无症状。
尿动力学评分是监测脂肪脊膜脊髓膨出患儿的有用工具，因为它与症状的存在有良好的相关性。
