Long-term urodynamic follow up in pediatric spinal cord injury.

Less than 5% of all spinal cord injuries occur in children under 16 years of age. We have followed up 40 children with spinal cord injury at our medical center. The patients have an average age at presentation of 9.0 years (range newborn to 17 years) and have a mean follow up of 46.1 months (range 1 to 240 months). Twenty-two patients have cervical injuries, 13 thoracic and five have lumbar injuries. Bladder management in this group includes 11 patients with reflex voiding and 29 patients combining anticholinergic medication with intermittent catheterization. Twenty-eight patients have a follow up for more than 1 year. Review of the video urodynamics in this group has shown good function and preservation of the urinary tract in 25 of 28 patients. Treatment failures can be attributed to noncompliance with recommended voiding regimens. Upper tract surveillance using intravenous pyelogram or renal ultrasound has shown preservation of the upper tracts in all patients with anatomically normal lower tracts. We recommend aggressive follow up in this group of patients with yearly renal ultrasound and video urodynamics every 1-2 years to monitor urinary tract function.