Arlen Angela M, Dudley Anne G, Kieran Kathleen
Department of Urology, Yale University School of Medicine, New Haven, CT, USA.
Division of Urology, Connecticut Children's Medical Center, Hartford, CT, USA.
Transl Androl Urol. 2020 Oct;9(5):2358-2369. doi: 10.21037/tau-19-771.
While the worldwide incidence of newborns with spinal dysraphism is decreasing, the majority of children now survive and reach adulthood, creating new challenges in patient management and long-term care. Despite medical and surgical advances with a subsequent decline in mortality, spina bifida continues to be a major cause of chronic disability and affected individuals face increased mortality in adulthood. The majority of spina bifida patients have neurogenic bladder. Reconstructive and diverting procedures may increase the neoplastic risk in the urinary tract over time, however bladder dysfunction itself may be a risk factor, therefore patients, caregivers, and physicians must be aware of the baseline risk of cancer in patients with neurogenic bladder, in addition to routine cancer screening. Optimal treatment of myelomeningocele requires a multidisciplinary care team to prevent and manage potential sequelae that may affect function, quality of life, and survival.
虽然全球脊柱裂新生儿的发病率正在下降，但现在大多数患儿存活至成年，这给患者管理和长期护理带来了新的挑战。尽管医学和外科手术取得了进展，死亡率随之下降，但脊柱裂仍然是慢性残疾的主要原因，受影响的个体在成年期面临更高的死亡率。大多数脊柱裂患者患有神经源性膀胱。随着时间的推移，重建和改道手术可能会增加尿路的肿瘤风险，然而膀胱功能障碍本身可能就是一个风险因素，因此患者、护理人员和医生除了进行常规癌症筛查外，还必须了解神经源性膀胱患者的基线癌症风险。脊髓脊膜膨出的最佳治疗需要一个多学科护理团队，以预防和管理可能影响功能、生活质量和生存的潜在后遗症。
