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Spina Bifida

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Book cover Urological Emergencies

Part of the book series: Current Clinical Urology ((CCU))

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Abstract

Spina bifida refers to a spectrum of congenital neural tube defects that can lead to mild to severe lower extremity, bladder, bowel, and sensory deficits. In this chapter, we highlight the pathogenesis of spina bifida, the recent advances in the surgical management of open neural tube defects, the surgical management of the consequences of neuropathic bowels and bladders, and the clinical scenarios of spina bifida interventions that may be experienced by emergency care providers. We also provide information to emergency care providers regarding the optimal diagnostic tests helpful in assessing spina bifida patients in extremis.

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References

  1. Hankinson TC, Anderson RCE, Feldstein N. Myelomeningocele and myelocystocele. In: Winn HR, editor. Youmans neurological surgery spine disorders in children. 6th ed. Philadelphia: Elsevier/Saunders; 2011.

    Google Scholar 

  2. Centers for Disease Control and Prevention. Recommendations for the use of folic acid to reduce the number of cases of spina bifida and other neural tube defects. MMWR Morb Mortal Wkly Rep. 1992;41:1–6.

    Google Scholar 

  3. US Food Drug Administration. Food standards: amendment of standards of identity for enriched grain products to require addition of folic acid. Fed Regist. 1996;61:8781–97.

    Google Scholar 

  4. Honein MA, Paulozzi LJ, Mathews TJ, et al. Impact of folic acid fortification of the US food supply on the occurrence of neural tube defects. JAMA. 2001;285:2981–6.

    Article  PubMed  CAS  Google Scholar 

  5. Boulet SL, Yang Q, Mai C, et al. Trends in the postfortification prevalence of spina bifida and anencephaly in the United States. Birth Defects Res A Clin Mol Teratol. 2008;82:527–32.

    Article  PubMed  CAS  Google Scholar 

  6. Au KS, Ashley-Koch A, Northrup H. Epidemiologic and genetic aspects of spina bifida and other neural tube defects. Dev Disabil Res Rev. 2010;16(1):6–15.

    Article  PubMed  Google Scholar 

  7. Adzick NS, Thom EA, Spong CY, Brock III JW, et al. A randomized trial of prenatal versus postnatal repair of myelomeningocele. N Engl J Med. 2011;364(11):993–1004.

    Article  PubMed  CAS  Google Scholar 

  8. Koh CJ, DeFilippo RE, Borer JG, et al. Bladder and external urethral sphincter function after prenatal closure of myelomeningocele. J Urol. 2006;176(5):2232–6.

    Article  PubMed  Google Scholar 

  9. Holmes NM, Nguyen HT, Harrison MR, et al. Fetal intervention for myelomeningocele: effect on postnatal bladder function. J Urol. 2001;166(6):2383–6.

    Article  PubMed  CAS  Google Scholar 

  10. Clayton DB, Tanaka ST, Thomas JC, et al. Long-term urological impact of fetal myelomeningocele closure. J Urol. 2011;186:1581–7.

    Article  PubMed  Google Scholar 

  11. Carr MC. Fetal myelomeningocele repair: urologic aspects. Curr Opin Urol. 2007;17:257–62.

    Article  PubMed  Google Scholar 

  12. Welk BK, Afshar K, Rapoport D, et al. Complications of the catheterizable channel following continent urinary diversion: their nature and timing. J Urol. 2008;180:1856–60.

    Article  PubMed  Google Scholar 

  13. Graf JL, Strear C, Bratton B, et al. The antegrade continence enema procedure: a review of the literature. J Pediatr Surg. 1998;33:1294–6.

    Article  PubMed  CAS  Google Scholar 

  14. DeFoor W, Tackett L, Minevich E, et al. Risk factors for spontaneous bladder perforation after augmentation cystoplasty. Urology. 2003;62:737–41.

    Article  PubMed  Google Scholar 

  15. Joseph DB. Current approaches to the urologic care of children with spina bifida. Curr Urol Rep. 2008;9:151–7.

    Article  PubMed  Google Scholar 

  16. Stein JP, Skinner DG. Orthotopic urinary diversion. In: Wein AW et al., editors. Campbell–Walsh urology. 9th ed. Philadelphia: Elsevier/Saunders; 2007.

    Google Scholar 

  17. McDougal WS. Metabolic complications of urinary intestinal diversion. J Urol. 1992;147:1199–207.

    PubMed  CAS  Google Scholar 

  18. Adams RC, Vachha B, Samuelson ML, et al. Incidence of new onset metabolic acidosis following enteroplasty for myelomeningocele. J Urol. 2010;183:302–5.

    Article  PubMed  Google Scholar 

  19. Hensle TW, Gilbert SM. A review of metabolic consequences and long-term complications of enterocystoplasty in children. Curr Urol Rep. 2007;8:157–62.

    Article  PubMed  Google Scholar 

  20. McDougal WS, Koch MO, Shands C, et al. Bony demineralization following urinary intestinal diversion. J Urol. 1988;140:853–5.

    PubMed  CAS  Google Scholar 

  21. Stein R, Wiesner C, Beetz R, et al. Urinary diversion in children and adolescents with neurogenic bladder: the Mainz experience. Part I: bladder augmentation and bladder substitution therapeutic algorithms. Pediatr Nephrol. 2005;20:920–5.

    Article  PubMed  Google Scholar 

  22. Gosalbez R, Woodard J, Broeker B, et al. Metabolic complications of the use of stomach for urinary reconstruction. J Urol. 1993;150:710–2.

    PubMed  Google Scholar 

  23. DeFoor W, Minevich E, Reddy P, et al. Bladder calculi after augmentation cystoplasty: risk factors and prevention strategies. J Urol. 2004;172:1964–6.

    Article  PubMed  Google Scholar 

  24. Nguyen DH, Bain MA, Salmonson KL, et al. The syndrome of dysuria and hematuria in pediatric urinary reconstruction with stomach. J Urol. 1993;150:707–9.

    PubMed  CAS  Google Scholar 

  25. Metcalfe PD, Rink RC. Bladder augmentation: complications in the pediatric population. Curr Urol Rep. 2007;8:152–6.

    Article  PubMed  Google Scholar 

  26. Al-Marhoon MS, Sarhan OM, Awad BA, et al. Comparison of endourological and open cystolithotomy in the management of bladder stones in children. J Urol. 2009;181:2684–8.

    Article  PubMed  Google Scholar 

  27. Metcalfe PD, Cain MP, Kaefer M, et al. What is the need for additional bladder surgery after bladder augmentation in childhood? J Urol. 2006;176:1801–5.

    Article  PubMed  CAS  Google Scholar 

  28. Metcalfe PD, Casale AJ, Kaefer RM, et al. Spontaneous bladder perforations: a report of 500 augmentations in children and analysis of risk. J Urol. 2006;175:1466–71.

    Article  PubMed  CAS  Google Scholar 

  29. Shekarriz B, Upadhyay J, Demirbilek S, et al. Surgical complications of bladder augmentation: comparison between various enterocystoplasty in 133 patients. Urology. 2000;55:122–8.

    Article  Google Scholar 

  30. Quagliano PV, Delair SM, Malhotra AK. Diagnosis of blunt bladder injury: a prospective comparative study of computed tomography cystography and conventional retrograde cystography. J Trauma. 2006;61(2):421–2.

    Article  Google Scholar 

  31. Deck AJ, Shaves S, Talner L, et al. Computerized tomography cystography for the diagnosis of traumatic bladder rupture. J Urol. 2000;164:43–6.

    Article  PubMed  CAS  Google Scholar 

  32. Barker GM, Lackgren G, Stenberg A, et al. Distal shunt obstruction in children with myelomeningocele after bladder perforation. J Urol. 2006;176:1726–8.

    Article  PubMed  CAS  Google Scholar 

  33. Arnell K, Olsen L. Distal catheter obstruction from non-infectious cause in ventriculo-peritoneal shunted children. Eur J Pediatr Surg. 2004;14:245–9.

    Article  PubMed  CAS  Google Scholar 

  34. Wu TS, Pearson TC, Meiners S, Daugharthy J. Bedside ultrasound diagnosis of a traumatic bladder rupture. J Emerg Med. 2011;41(5):520–3.

    Article  PubMed  Google Scholar 

  35. Newport JP, Dusseault BN, Butler C, et al. Gadolinium-enhanced computed tomography cystogram to diagnose bladder augment rupture in patients with iodine sensitivity. Urology. 2008;71:984.e9–e11.

    Article  Google Scholar 

  36. Osman Y, El-Tabey N, Mohsen T, et al. Nonoperative treatment of isolated posttraumatic intraperitoneal bladder rupture in children—is it justified? J Urol. 2005;173:955–7.

    Article  PubMed  Google Scholar 

  37. Leyland JW, Masters JG. Conservative management of an intraperitoneal rupture of an augmentation cystoplasty and continent urinary diversion in an adult. J Urol. 2003;170:524.

    Article  PubMed  Google Scholar 

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Correspondence to Thomas S. Lendvay MD .

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Lendvay, T.S., Su, R. (2013). Spina Bifida. In: Wessells, H. (eds) Urological Emergencies. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-423-4_25

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  • DOI: https://doi.org/10.1007/978-1-62703-423-4_25

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  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-62703-422-7

  • Online ISBN: 978-1-62703-423-4

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