NEUROGENIC BLADDER IN IMPERFORATE ANUS – BOY
Persistent Urinary Incontinence and febrile UTI in 5-year-old boy with VATER. VATER (or VACTERL) association is a disorder that affects many body systems. VACTERL stands for vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities. Epidemiology: 1:4,000 to 1:5,000 live births. Neurogenic Bladder: Acontractile or hypo-contractile detrusor +/- sphincter incompetence.
URODYNAMIC TESTING IN SPINAL DYSRAPHISM – LOWER URINARY TRACT – BABY GIRL # 2
Cystogram of a neurogenic bladder – note abnormal bladder shape, trabeculations and presence of detrusor sphincter dyssynergia as depicted by arrow
LIPOMENINGOCELE
Fatty tissue in defect +/- meninges and neural elements. Associated with spina bifida.
RENAL ULTRASOUND REVEALING HYDRONEPHROSIS IN SPINAL DYSRAPHISM
Renal ultrasound (asap): - Noninvasive, no exposure to ionizing radiation. - Good views of renal parenchyma and renal pelvis; dilated ureter may be identified. - Baseline for comparison
URODYNAMIC TESTING IN SPINAL DYSRAPHISM – LOWER URINARY TRACT – BOY
Study to assess bladder function and determine if upper tracts are at risk. Note irregular bladder shape with abrupt cut off of urethra suggesting detrusor sphincter dyssenergia.
AUGMENTATION ENTEROCYCTOPLASTY IN 15 YEAR OLD #1
Part of the urinary bladder is divided and a detubularized bowel segment is asastomased to the bladder to achieve better bladder compliance and capacity. Purpose: - Increase bladder capacity - Reduce bladder pressures - Restore urinary continence - Alleviate VUR (vesicoureteral reflux)
NEUROGENIC BLADDER IN INPERFORATE ANUS-GIRL
Mixed Urinary Incontinence in 5 year old girl with VACTERL. VACTERL association is a disorder that affects many body systems. VACTERL stands for vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities. Neurogenic Bladder: underactive.
IMAGING SHOWING SPINAL DYSRAPHISMS
A general term used to describe a collection of congenital abnormalities that include defects in the vertebrae, and spinal cord or nerve roots. Generally, all forms have some impact on bowel and bladder function.
NEUROGENIC BLADDER IN CEREBRAL PALSY
Increasing difficulty voiding in 17 year old with CP, severe spasticity and baclofen pump.
SPINAL DYSRAPHISM - 8 YEAR OLD GIRL
Evaluation and management of Spinal Dysraphism. Eight-year-old girl on CIC and Oxybutynin, Rare UI but frequent UTI and Hydronephrosis on Renal U/S. CIC: clean intermittent catheterization.
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152-containment
URODYNAMIC TESTING IN SPINAL DYSRAPHISM – LOWER URINARY TRACT – BABY GIRL # 2
Cystogram of a neurogenic bladder – note abnormal bladder shape, trabeculations and presence of detrusor sphincter dyssynergia as depicted by arrow
SPINAL DYSRAPHISM - BOY
Evaluation and management of Spinal Dysraphism. Ten-year-old boy on CIC but off his antimuscarinic. CIC: clean intermittent catheterization.
SPINAL DYSRAPHISMS: MYELOMENINGOCELE (MMC)
MMC- defect of lower spine, involving meninges and spinal tissue which often results in bowel and bladder dysfunction.