Chair and Department of Descriptive and Topographic Anatomy, School of Medicine with Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland.
Higher School of Strategic Planning in Dąbrowa Górnicza, Śląski Uniwersytet Medyczny w Katowicach, Klinika Chirurgii i Urologii Dziecięcej, Katowice, Poland.
Neurourol Urodyn. 2018 Nov;37(8):2792-2798. doi: 10.1002/nau.23771. Epub 2018 Jul 30.
The aim of the study was to evaluate the lower urinary tract function, frequency UTI, the degree of social urine continence, and the occurrence of constipation in children who underwent prenatal or postnatal surgery for MMC.
Seventy-two patients with MMC were assessed and divided into the prenatal group (36 patients) and the postnatal one (36 patients). All children, regardless the time of operation, received the same treatment after birth. The urodynamic tests, USG, cystourethrography were performed in all patients along with evaluation of the UTI's, social urine continence, and presence of constipation.
Urodynamic and imaging studies showed no differences between the test groups. Children from the prenatally operated group showed statistically significant lower number of urinary tract infections, better urine continence, and less frequent constipation.
Prenatal MMC repair ensures statistically significant improvement of the degree of social urinary continence, reducing the risk of urinary infections and constipation. Time of MMC repair does not statistically influence the urodynamic tests results and the urodynamic parameters are not the prognostic elements to assess the social urinary continence possibility in patients with the neurogenic bladder.
本研究旨在评估接受产前或产后手术治疗巨大膀胱-尿道-阴道瘘（MMC）的患儿的下尿路功能、尿路感染（UTI）频率、社会尿控程度和便秘发生情况。
对 72 例 MMC 患儿进行评估，分为产前组（36 例）和产后组（36 例）。所有患儿出生后均接受相同的治疗，无论手术时间如何。所有患儿均进行尿动力学检查、超声检查、膀胱尿道造影，并评估 UTI、社会尿控和便秘情况。
尿动力学和影像学研究显示两组之间无差异。产前手术组患儿尿路感染次数明显减少，尿控更好，便秘更少见。
产前 MMC 修复可显著改善社会尿控程度，降低尿路感染和便秘的风险。MMC 修复的时间不会对尿动力学检查结果产生统计学影响，且尿动力学参数不是评估神经源性膀胱患者社会尿控可能性的预后因素。
