EFFECT OF SURGICAL REPAIR ON THE NEUROUROLOGIC FUNCTION IN INFANTS WITH LIPOMENINGOCELE

Eighteen children under the age of 1 year underwent surgery for lipome ningocele at our institution between 1983 and 1991. All the patients h ad neurologic exams and urodynamic studies (UDS) including a cystometr ogram and electromyography of the external urethral spincter pre- and postoperatively. The surgical procedure performed included an untether ing of the spinal cord, laser debulking of the lipoma and placement of a dural graft. All the infants presented with a lesion on their back. Two of 10 infants with a normal neurological exam had abnormal UDS pr eoperatively. Early surgery normalized abnormal preoperative UDS in 5 of 6 (83%) infants with abnormal UDS. Moreover, 3 of 8 (38%) infants w ith an abnormal neurological exam preoperatively improved after surger y and none worsened. These observations suggest that abnormal urinary tract function in infants with lipomeningocele may be reversible with early prophylactic surgery.