THE UROLOGICAL FATE OF YOUNG-ADULTS WITH MYELOMENINGOCELE - A 3 DECADE FOLLOW-UP-STUDY

Objective: Virtually all patients with myelomeningocele suffer from ne urogenic disorder of the bladder. Problems with incontinence are commo n and there is also a risk of deterioration of renal function. The aim of the present study was to determine the long-term urological fate o f this patient group. Patients and Methods: Twelve young adults with m yelomeningocele were interviewed and their records reviewed. Results: The patients started clean intermittent catheterization (CIC) at the a ge of 10-21 years. Three patients underwent urological surgery prior t o the start of CIC. This was also the case for 3 patients after having started CIC. Only 1 patient is completely continent. In the rest, the degree of incontinence varies. With few exceptions, the glomerular fi ltration rate was well preserved. Six of the incontinent patients had, on at least one occasion, denied incontinence to his doctor. Conclusi on: It seems that the prognosis is good as far as renal function is co ncerned. However, continence is a prerequisite for good social adjustm ent. An obstacle for a rational treatment of incontinence, in the adol escent patient group, is the patient's strong tendency to underreport the actual incontinence situation. Thus, every effort must be made in order to obtain a correct history. In patients with validated incontin ence, an aggressive treatment policy, including surgical intervention, is justified.