1/15. An unexpected complicationof the remote-controlled intraurethral valve pump for urinary incontinence.We report an unexpected complication of the remote-controlled intraurethral valve pump in a patient with neurogenic bladder. A meningomyelocele patient with an atonic bladder received an intraurethral valve pump. Acute urinary retention was caused by a mucus clot obstructing the pump. Prior to extended clinical use, the remote-controlled intraurethral valve pump should be evaluated in prospective multicenter studies.- - - - - - - - - - ranking = 1keywords = meningomyelocele (Clic here for more details about this article) |
2/15. neural tube defects and the 13q deletion syndrome: evidence for a critical region in 13q33-34.neural tube defects (NTD) are common findings in the 13q deletion syndrome, but the relationship between the 13q- syndrome and NTDs is poorly understood. We present a child with a 13q deletion and lumbosacral myelomeningocele. This was a boy with microcephaly, telecanthus, minor facial anomalies, and ambiguous genitalia. Cytogenetic and fluorescence in situ hybridization analysis showed a de novo 46,XY,del(13)(q33.2-->qter) with no visible translocation. By using microsatellite markers, the deletion breakpoint was mapped to a 350-kb region between D13S274 and D13S1311 and was paternal in origin. An analysis of 13q deletions with NTDs, including the present case, suggests that a deletion in 13q33-34 is sufficient to cause an NTD. The deletions associated with NTDs are distal to and nonoverlapping with the previously defined critical region in 13q32 for the major malformation syndrome [Brown et al., 1999: Am J Hum Genet 57: 859-866]. Our analysis also suggests that one or more genes in 13q33-34 produces NTDs by haploinsufficiency.- - - - - - - - - - ranking = 2.0371601291668keywords = myelomeningocele (Clic here for more details about this article) |
3/15. Ureteropelvic junction obstruction due to inflammatory pseudotumor masquerading as hydronephrosis because of a neuropathic bladder in a child with myelomeningocele.Inflammatory pseudotumors (IPTs), also known as inflammatory myofibroblastic tumors, are rare solid lesions, generally thought to be benign, which have been described in a variety of locations. We report a case of a child with a neuropathic bladder who developed a pseudotumor of the retroperitoneum that caused progressive ureteral obstruction distal to the ureteropelvic junction. hydronephrosis as a complication of IPTs has been described with bladder and uterine IPTs; however, in our review of published reports, we found no reported cases of a retroperitoneal IPT causing proximal ureteral obstruction in a pediatric patient.- - - - - - - - - - ranking = 8.1486405166671keywords = myelomeningocele (Clic here for more details about this article) |
4/15. Experience with non-sterile intermittent self-catheterization.Although a patient subjected to intermittent self-catheterization must carry a catheter and catheterize himself under a non-sterile technique at regular intervals this method is considered the best one available for patients who lead an active social life. When family cooperation is available intermittent catheterization is a cleaner procedure, causes less complications and is easier to manage for a patient confined to bed than the indwelling catheter, cystostomy or other urinary diversion procedures. The technique is also useful for patients with spinal cord injuries, promoting the early return of bladder activity and a life free of the catheter. It is an ideal method for children with meningomyelocele, after the upper tract has been maintained carefully by an indwelling catheter or cystostomy until the child is able to catheterize himself. In these cases a small capacity bladder may be enlarged using the colon and urinary incontinence may be corrected by other operative procedures. We have treated 26 patients with this technique, including 1 with a 17-year followup. The upper urinary tract has not deteriorated in any case and the urine has remained sterile in 39 per cent of the cases.- - - - - - - - - - ranking = 1keywords = meningomyelocele (Clic here for more details about this article) |
5/15. Upper urinary tract deterioration after implantation of artificial urinary sphincter.The preoperative urodynamic evaluations of twenty patients with myelomeningocele who had had artificial sphincter implantation because of urinary incontinence were reviewed. Four patients developed hydronephrosis and severe impairment of renal function between two and six years after implantation of the artificial sphincter. The condition was partly reversible after removal of the artificial sphincter. The urodynamic evaluation prior to implantation revealed in the four mentioned patients compared to the 16 patients with normal upper urinary tract, a tendency to lower bladder compliance, lower bladder capacity and more severe detrusor hyperreflexia, but it was not possible to make a clear discrimination between the two groups. attention is drawn to this unfortunate combination of effects after artificial sphincter implantation. Periodic control of the upper urinary tract by urography is recommended.- - - - - - - - - - ranking = 2.0371601291668keywords = myelomeningocele (Clic here for more details about this article) |
6/15. Behavioral methods for teaching self-catheterization skills to anxious children with myelomeningocele.A behavior-based protocol was developed which outlined all necessary behaviors for successful self-catheterization to an anxious child with myelomeningocele. The subject had been wearing diapers daily since birth, and he expressed fear of pain and lacked confidence because of previous unsuccessful attempts. The present protocol included progressive muscle relaxation, guided visual imagery, and behavioral rehearsal that was implemented by his parents. Data collected showed daily successful intermittent self-catheterization skills two weeks and 6 months posttreatment. Thus, an alternative to traditional educational methods exists that can successfully enhance the acquisition of self-catheterization skills.- - - - - - - - - - ranking = 10.185800645834keywords = myelomeningocele (Clic here for more details about this article) |
7/15. Prostatic suppuration and destruction in patients with myelodysplasia: a newly recognized entity.Prostatic abscess is an unusual occurrence in the era of modern antibiotics. In 5 patients with myelodysplasia extravasation of contrast material to the boundaries of the prostate was noted on voiding cystourethrography. All patients were adolescents who, with varying degrees of compliance, had managed the neurogenic bladder with intermittent catheterization since childhood. All patients had chronic urinary tract infections. In 2 patients subjected to transurethral resection the prostatic parenchyma was completely replaced by the suppurative process. Neither patient demonstrated much clinical improvement after resection. The possible etiological factors and various therapeutic options are discussed for the previously unreported condition of chronic prostatic abscess in myelomeningocele patients.- - - - - - - - - - ranking = 2.0371601291668keywords = myelomeningocele (Clic here for more details about this article) |
8/15. Fascial sling to correct male neurogenic sphincter incompetence: the McGuire/Raz approach.We report the surgical approach used in 4 male myelomeningocele patients suffering from severe urinary incontinence owing to poor bladder compliance and sphincter incompetence. While bladder compliance was corrected by enlargement cystoplasty the sphincteric incompetence was treated by an autologous fascial sling around the bladder neck with excellent results. We consider this operation as an alternative to the artificial urinary sphincter in cases of male neurogenic sphincter incontinence.- - - - - - - - - - ranking = 2.0371601291668keywords = myelomeningocele (Clic here for more details about this article) |
9/15. Mucinous adenocarcinoma of bladder. Case associated with extensive intestinal metaplasia of urothelium in patient with nonfunctioning bladder for twelve years.A mucin-secreting adenocarcinoma of the bladder arose in a fifty-one-year-old man twelve years after he had an ileal conduit and urinary diversion for a neurogenic bladder which was due to a myelomeningocele. The patient presented with a mucinous penile discharge, and cystoscopy showed several papillary tumors with mucoid material coating the intervening mucosa. Examination of the resected bladder showed almost total intestinal metaplasia of the urothelium with numerous foci of dysplasia, adenocarcinoma in situ, papillary and invasive adenocarcinoma. The clinical and pathologic features of this case and the risk of carcinoma developing in a nonfunctioning bladder are discussed.- - - - - - - - - - ranking = 2.0371601291668keywords = myelomeningocele (Clic here for more details about this article) |
10/15. Acquired vesicocolonic fistula in a child: a complication in management of a neurogenic bladder.A 6-year-old girl with meningomyelocele and a neurogenic bladder was managed with clean intermittent catheterization. After 3 months she developed a vesicocolonic fistula, demonstrated on cystography. This is the first such complication reported since this type of management was popularized.- - - - - - - - - - ranking = 1keywords = meningomyelocele (Clic here for more details about this article) |
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