NEUROVESICAL DYSFUNCTION IN PATIENTS WITH ANORECTAL-MALFORMATIONS

The aim of the study is to investigate the incidence of neurovesical d ysfunction (NVD) in patients with operated anorectal malformations (AR M) and its relationship with sacral abnormalities. Between September 1 992 and April 1994 cystomictiometric and electromyography investigatio ns were performed for 33 patients operated on for anal atresia. The ag e of these 14 male and 19 female patients ranged between 1-17 years (m ean age: 7.7). The level of ARM was supralevator in 10 patients and in fralevator in 23 patients. The x-ray of 14 patients showed lumbosacral abnormalities. In urodynamic investigation, NVD was observed in 15 pa tients (45.4%). 4 of the patients had signs developed secondary to org anic subvesical obstruction. The urodynamic results of 14 patients wer e in the normal range. NVD rate was found to be 70% in patients with s upralevator anal atresia, 34.7% in patients with infralevator anal atr esia, 64.2% in patients with sacral abnormalities and 31.5% in patient s with no sacral abnormality. Conclusion: NVD incidence increased in p atients with supralevator ARM and in patients with sacral abnormalitie s. However, presence of infralevator abnormality or absence of sacral abnormality does not eliminate NVD. We think that, whenever NVD is sus pected in a patient with ARM, urodynamic investigations should be perf ormed as a routine investigation of the urinary tract.