Abstract：
BACKGROUND: Recent decades have seen changes in the urological treatment of myelomeningocele (MMC). We aimed to evaluate the urological outcomes in post-pubertal patients and to clarify associations with walking status, hydrocephalus, and sex.
METHODS: A retrospective study of 103 MMC patients at their final pediatric urological control. Urological procedures, the necessity for Clean Intermittent Catheterization (CIC) and anticholinergic medication, the state of continence, renal ultrasound findings, and serum creatinine values were assessed.
RESULTS: The median age of the patients was 18 years (IQR 16.7-19.6), with 51 (49.5%) being female. Renal function was preserved in all but of one, who presented with mild hydronephrosis. 38 patients walked without assistance, 46 used wheelchairs. Most patients (93%) utilized CIC, and 83% had interventions for overactive or poorly compliant bladder, including anticholinergic medication (47%), Botox treatments (35%), or bladder augmentation (36%). Nearly half (45%) had undergone bladder neck procedures. Continence status revealed 55% fully continent, 18% were rarely incontinent, and 26% were incontinent daily, with most episodes limited to droplet leakage. Incontinence was not associated with the ambulatory status, hydrocephalus, or sex (p = 0.08, >0.99, and 0.07 respectively).
CONCLUSIONS: Renal function was effectively maintained with our treatment strategy; however, daily incontinence episodes occurred in one out of four patients, with an additional 18% experiencing occasional rare incontinence episodes. Incontinence, when present, was mostly mild. We found no association between patient characteristics, treatment approach, and continence. Emphasizing incontinence treatment becomes a mainstay in future studies.
METHODS: IV.
METHODS: A retrospective study of 103 MMC patients at their final pediatric urological control. Urological procedures, the necessity for Clean Intermittent Catheterization (CIC) and anticholinergic medication, the state of continence, renal ultrasound findings, and serum creatinine values were assessed.
RESULTS: The median age of the patients was 18 years (IQR 16.7-19.6), with 51 (49.5%) being female. Renal function was preserved in all but of one, who presented with mild hydronephrosis. 38 patients walked without assistance, 46 used wheelchairs. Most patients (93%) utilized CIC, and 83% had interventions for overactive or poorly compliant bladder, including anticholinergic medication (47%), Botox treatments (35%), or bladder augmentation (36%). Nearly half (45%) had undergone bladder neck procedures. Continence status revealed 55% fully continent, 18% were rarely incontinent, and 26% were incontinent daily, with most episodes limited to droplet leakage. Incontinence was not associated with the ambulatory status, hydrocephalus, or sex (p = 0.08, >0.99, and 0.07 respectively).
CONCLUSIONS: Renal function was effectively maintained with our treatment strategy; however, daily incontinence episodes occurred in one out of four patients, with an additional 18% experiencing occasional rare incontinence episodes. Incontinence, when present, was mostly mild. We found no association between patient characteristics, treatment approach, and continence. Emphasizing incontinence treatment becomes a mainstay in future studies.
METHODS: IV.
摘要：
背景：近几十年来，脊髓膜膨出（MMC）的泌尿外科治疗发生了变化。我们旨在评估青春期后患者的泌尿外科结局，并阐明与步行状态的关系。脑积水,和性爱。
方法：对103名MMC患者进行最终儿科泌尿外科控制的回顾性研究。泌尿外科手术,清洁间歇性导尿（CIC）和抗胆碱能药物的必要性，节制的状态，肾脏超声检查结果，和血清肌酐值进行评估。
结果：患者的中位年龄为18岁（IQR16.7-19.6），51（49.5%）为女性。除了一个人，肾功能都得到了保留，出现轻度肾积水的人.38名患者在没有帮助的情况下行走，46辆二手轮椅。大多数患者（93%）使用CIC，83％的人对膀胱过度活动或依从性差进行了干预，包括抗胆碱能药物（47%），肉毒素治疗（35%），或膀胱扩张(36%)。将近一半（45％）接受了膀胱颈手术。延续状态显示55%全大陆，18%的人很少失禁，每天有26%的人失禁，大多数事件仅限于液滴泄漏。尿失禁与卧床状态无关，脑积水,或性别（分别为p=0.08，>0.99和0.07）。
结论：我们的治疗策略可有效维持肾功能；然而，每天尿失禁发作发生在四分之一的患者，另有18%的人偶尔会出现罕见的尿失禁。失禁，当存在时,大多是温和的。我们发现患者特征之间没有关联，治疗方法,和节制。强调失禁治疗成为未来研究的支柱。
方法：IV.
方法：对103名MMC患者进行最终儿科泌尿外科控制的回顾性研究。泌尿外科手术,清洁间歇性导尿（CIC）和抗胆碱能药物的必要性，节制的状态，肾脏超声检查结果，和血清肌酐值进行评估。
结果：患者的中位年龄为18岁（IQR16.7-19.6），51（49.5%）为女性。除了一个人，肾功能都得到了保留，出现轻度肾积水的人.38名患者在没有帮助的情况下行走，46辆二手轮椅。大多数患者（93%）使用CIC，83％的人对膀胱过度活动或依从性差进行了干预，包括抗胆碱能药物（47%），肉毒素治疗（35%），或膀胱扩张(36%)。将近一半（45％）接受了膀胱颈手术。延续状态显示55%全大陆，18%的人很少失禁，每天有26%的人失禁，大多数事件仅限于液滴泄漏。尿失禁与卧床状态无关，脑积水,或性别（分别为p=0.08，>0.99和0.07）。
结论：我们的治疗策略可有效维持肾功能；然而，每天尿失禁发作发生在四分之一的患者，另有18%的人偶尔会出现罕见的尿失禁。失禁，当存在时,大多是温和的。我们发现患者特征之间没有关联，治疗方法,和节制。强调失禁治疗成为未来研究的支柱。
方法：IV.
