Foster L S, Kogan B A, Cogen P H, Edwards M S
Department of Urology, University of California School of Medicine, San Francisco 94143-0738.
J Urol. 1990 May;143(5):984-6. doi: 10.1016/s0022-5347(17)40159-5.
We evaluated preoperative and postoperative bladder function in 31 consecutive patients who underwent definitive operative correction of lipomyelomeningocele. Of 12 patients less than 1.5 years old at operation, bladder function was normal preoperatively and postoperatively in 5 (42%) and normalized postoperatively in 4 (33%). In 5 patients (42%) abnormal urodynamic findings were the only sign of neurological abnormality. Of the 19 patients older than 1.5 years at operation bladder function was normal preoperatively and postoperatively in only 4 (21%), and normalized postoperatively in none. We conclude that the majority of patients with lipomyelomeningocele have bladder dysfunction, and that in some cases this dysfunction can be prevented and/or reversed by early neurosurgical intervention. Urodynamic assessment is helpful as part of the neurological evaluation and in directing patient care.
我们评估了31例接受脂肪脊髓脊膜膨出确定性手术矫正的连续患者术前和术后的膀胱功能。在手术时年龄小于1.5岁的12例患者中,5例(42%)术前和术后膀胱功能正常,4例(33%)术后膀胱功能恢复正常。5例(42%)患者尿动力学检查异常是神经功能异常的唯一表现。在手术时年龄大于1.5岁的19例患者中,只有4例(21%)术前和术后膀胱功能正常,无一例术后恢复正常。我们得出结论,大多数脂肪脊髓脊膜膨出患者存在膀胱功能障碍,并且在某些情况下,这种功能障碍可通过早期神经外科干预得到预防和/或逆转。尿动力学评估作为神经学评估的一部分以及指导患者护理是有帮助的。