urinary_continence [Neurosurgery Wiki]

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Macedo et al., from [[São Paulo]], selected from the database patients aged 5 years or older for evaluation of urinary and fecal [[continence]]. They reviewed all [[chart]]s and completed a [[questionnaire]] to study aspects of urinary and fecal continence.

They identified 14 patients, i.e., 4 (28.6%) males and 10 (71.4%) females. The mean age at [[Myelomeningocele]] (MMC) surgery was 25.6 gestational weeks. The uro-dynamic class was high-risk in 6 (42.9%), incontinent in 4 (28.6%), hypocontractile in 1 (7.1%), and normal in 3 (21.4%) patients. Three patients had undergone surgery (2 augmentations, i.e., 1 in association with a left colon ACE Macedo-Malone procedure and 1 mini-sling urethroplasty). Twelve patients underwent clean intermittent catheterization (CIC) (85.7%). Only 3 (21.4%) patients had no urinary leakage. Eleven patients (78.6%) used diapers. Eight patients (57.2%) underwent retrograde rectal irrigation and 11 (78.6%) complained of fecal loss. Eleven patients (78.6%) did not report an impact on their self-esteem.

Despite the use of CIC in 85.7% of the cases, the continence rate in MMC patients operated on in utero was low and 78.6% of the patients used diapers. This data can be used to educate parents about future conditions of their 5-year-old children and may stimulate the debate regarding further attempts (surgical or not) to improve fecal and [[urinary continence]]
((Macedo A Jr, Cavalheiro S, Moron A, Lobountchenko T, Dini FS, Ottoni SL,
Garrone G, Ligori R, Leal da Cruz M. Urinary and Fecal Continence in 5-Year-Old
Patients Who Underwent in utero Myelomeningocele Repair: A Prospective Study.
Fetal Diagn Ther. 2019 Mar 18:1-4. doi: 10.1159/000496791. [Epub ahead of print] 
PubMed PMID: 30884481.
)).