THE LONG-TERM IMPACT OF UROLOGICAL MANAGEMENT ON THE QUALITY-OF-LIFE OF CHILDREN WITH SPINA-BIFIDA

To evaluate the integration of children with spina bifida into adult s ociety and identify important urological factors 20 female and 18 male spina bifida patients older than 18 years were evaluated with respect to urological management and complications. A detailed questionnaire concerning educational achievements, living arrangements, employment a nd interpersonal relationships was completed and compared to similar d ata obtained from the 1990 United States census. Educational achieveme nt and living arrangements for most patients were comparable to age ma tched peers in the general population and were independent of gender o r method of urinary management. The only statistically significant fac tor related to a positive outcome was female gender in the areas of em ployment (p < 0.014) and sexual relationships (p < 0.005). Female spin a bifida patients adapted better to adult society than their male coun terparts. Intestinal urinary conduits were detrimental to long-term re nal function.