LONG-TERM URODYNAMIC FOLLOW-UP IN PEDIATRIC SPINAL-CORD INJURY

Less than 5% of all spinal cord injuries occur in children under 16 ye ars of age. We have followed up 40 children with spinal cord injury at our medical center. The patients have an average age at presentation of 9.0 years (range newborn to 17 years) and have a mean follow up of 46.1 months (range 1 to 240 months). Twenty-two patients have cervical injuries, 13 thoracic and five have lumbar injuries. Bladder manageme nt in this group includes 11 patients with reflex voiding and 29 patie nts combining anticholinergic medication with intermittent catheteriza tion. Twenty-eight patients have a follow up for more than 1 year. Rev iew of the video urodynamics in this group has shown good function and preservation of the urinary tract in 25 of 28 patients. Treatment fai lures can be attributed to noncompliance with recommended voiding regi mens. Upper tract surveillance using intravenous pyelogram or renal ul trasound has shown preservation of the upper tracts in all patients wi th anatomically normal lower tracts. We recommend aggressive follow up in this group of patients with yearly renal ultrasound and video urod ynamics every 1-2 years to monitor urinary tract function.