A 4-Year Prospective Urological Assessment of In Utero Myelomeningocele Repair-Does Gestational Age at Birth Have a Role in Later Neurogenic Bladder Pattern?

A 4-Year Prospective Urological Assessment of In Utero Myelomeningocele Repair-Does Gestational Age at Birth Have a Role in Later Neurogenic Bladder Pattern?

Author da Cruz, Marcela Leal Autor UNIFESP Google Scholar
Liguori, Riberto Autor UNIFESP Google Scholar
Garrone, Gilmar Autor UNIFESP Google Scholar
Ottoni, Sergio Leite Autor UNIFESP Google Scholar
Cavalheiro, Sergio Autor UNIFESP Google Scholar
Moron, Antonio Fernandes Autor UNIFESP Google Scholar
Macedo, Antonio, Jr. Autor UNIFESP Google Scholar
Abstract Purpose: Premature delivery is a major complication of in utero myelomeningocele repair. The prematurity rate in MOMS (Management of Myelomeningocele Study) was 79%, with a mean gestational age at birth of 34 weeks. We speculated that prematurity could also influence urological outcome in patients operated on prenatally for myelomeningocele. Materials and Methods: Beginning in November 2011, we prospectively followed a population of patients with myelomeningocele who had undergone in utero repair. Results: We compared patients based on gestational age at birth, ie younger than 34 weeks (group 1, 42 patients) and 34 weeks or older (group 2, 37 patients). Mean gestational age at birth was 28.3 weeks (range 25 to 33) in group 1 and 35.2 weeks (34 to 38) in group 2. Of the cases 47.5% in group 1 were classified as high risk, 35% as incontinent, 10% as hypocontractile and 7.5% as normal. By comparison, 54.5% of cases in group 2 were classified as high risk, 33.3% as incontinent and 12.1% as normal. Differences between the groups were not statistically significant. Mean followup was 27.9 months in group 1 and 24.3 months in group 2. Conclusions: Our results show that gestational age at birth has little impact on bladder pattern. These data reinforce the need to follow this population closely.
Keywords meningomyelocele
fetal therapies
urodynamics
prenatal diagnosis
xmlui.dri2xhtml.METS-1.0.item-coverage New York
Language English
Date 2017
Published in Journal Of Urology. New York, v. 197, n. 6, p. 1550-1554, 2017.
ISSN 0022-5347 (Sherpa/Romeo, impact factor)
Publisher Elsevier Science Inc
Extent 1550-1554
Origin http://dx.doi.org/10.1016/j.juro.2016.12.014
Access rights Closed access
Type Article
Web of Science ID WOS:000400896400083
URI https://repositorio.unifesp.br/handle/11600/54435

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