Mevorach R A, Bogaert G A, Baskin L S, Lazzaretti C C, Edwards M S, Kogan B A
Department of Urology, University of California School of Medicine, San Francisco, USA.
Br J Urol. 1996 Apr;77(4):593-6. doi: 10.1046/j.1464-410x.1996.93522.x.
To investigate lower urinary tract function in ambulatory children with myelomeningocele.
The urological course of 45 children with myelomeningocele who walked either independently (19 children) or with ankle-foot orthotics (26 children) was reviewed. Follow-up ranged from 9 months to 13.5 years (mean 4.75 years).
A normal pattern of voiding was observed both clinically and during urodynamic evaluation in only three of the 45 children, with the remainder displaying neurogenic lower urinary tract dysfunction. The independent walkers and those with orthotics did not differ in the spectrum of lower urinary tract dysfunction or other variables. Those patients with persistent incontinence underwent an initial urodynamic evaluation when older (mean 3.7 years versus 6.4 weeks in those who were continent).
Ambulatory children with myelomeningocele suffer the full spectrum of lower urinary tract dysfunction. Given the potential danger of untreated lower urinary tract dysfunction, ambulatory children with myelomeningocele should receive the same diagnostic and therapeutic attention as their peers with more overt neurological deficits.
研究能行走的脊髓脊膜膨出患儿的下尿路功能。
回顾了45例脊髓脊膜膨出患儿的泌尿病程，这些患儿要么能独立行走（19例），要么使用踝足矫形器行走（26例）。随访时间为9个月至13.5年（平均4.75年）。
45例患儿中只有3例在临床和尿动力学评估中观察到正常排尿模式，其余患儿均表现为神经源性下尿路功能障碍。能独立行走的患儿和使用矫形器的患儿在下尿路功能障碍范围或其他变量方面没有差异。那些持续性尿失禁的患儿在年龄较大时才进行初始尿动力学评估（平均3.7岁，而能自主控制排尿的患儿为6.4周）。
能行走的脊髓脊膜膨出患儿存在各种类型的下尿路功能障碍。鉴于未治疗的下尿路功能障碍存在潜在危险，能行走的脊髓脊膜膨出患儿应与有更明显神经功能缺损的同龄人一样接受相同的诊断和治疗关注。
