C Sanders1, C P Driver, A M K Rickwood. 1. Department of Paediatric Urology, Alder Hey Children's Hospital, Eaton Road, Liverpool, L12 2AP, UK.
Abstract
OBJECTIVE: To examine the hypothesis that because most patients with myelomeningocele and a positive anocutaneous reflex have a competent sphincteric mechanism they are more likely to be continent on intermittent catheterization than those with a negative reflex, and to become so with less need for adjunctive surgical treatment. PATIENTS AND METHODS: The study included 111 patients with myelomeningocele treated for urinary incontinence; their present means of treatment and the outcome achieved were assessed and related to the presence or absence of an anocutaneous reflex. RESULTS: Among 29 patients with a positive anocutaneous reflex, 26 (90%) are currently dry on a regimen of intermittent catheterization, as opposed 41 (50%) of the 82 with a negative reflex (P < 0.001). Two (7%) of those with a positive and 23 (28%) of those with a negative reflex have undergone adjunctive surgery (P=0.024). CONCLUSION: These findings are consistent with both aspects of the hypothesis detailed in the Objective.
OBJECTIVE: To examine the hypothesis that because most patients with myelomeningocele and a positive anocutaneous reflex have a competent sphincteric mechanism they are more likely to be continent on intermittent catheterization than those with a negative reflex, and to become so with less need for adjunctive surgical treatment. PATIENTS AND METHODS: The study included 111 patients with myelomeningocele treated for urinary incontinence; their present means of treatment and the outcome achieved were assessed and related to the presence or absence of an anocutaneous reflex. RESULTS: Among 29 patients with a positive anocutaneous reflex, 26 (90%) are currently dry on a regimen of intermittent catheterization, as opposed 41 (50%) of the 82 with a negative reflex (P < 0.001). Two (7%) of those with a positive and 23 (28%) of those with a negative reflex have undergone adjunctive surgery (P=0.024). CONCLUSION: These findings are consistent with both aspects of the hypothesis detailed in the Objective.
Authors: J Pannek; P M Braun; W Diederichs; M Hohenfellner; K P Jünemann; H Madersbacher; A Reitz; S Schumacher; M Stöhrer Journal: Urologe A Date: 2006-09 Impact factor: 0.639