Neuro-urological surveillance of Spina bifida in Morocco

H. Azanmasso, E. Tchonda, E. Alagnidé, S. Lahrabli, F. Lmidmani, A. E. Fatimi
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Abstract

Objective: Spina bifida is one of the first caused of disability with children in USA. This incidence was estimated to 3.5 per 10000 habitants. In France, it was mostly, 0.5 per 1000 habitants. The improvement in neuro surgy and in urology allowed a veritable reduction of mortality with spina bifida. Method: It was a retrospective descriptive and analytic study with children suffering of spina bifida and followed up between january 2013 and december 2015 at the department of Physical Medicine of Casablanca. Results: Twenty six patients were followed up. The average age was 11.9 +/- 5.8 years. These urinary disorders were frequency 100%, urinary incontinence 65.4%, urgency 73.1% and intermittent stream or training 46.2% with significant post void residual 26.9%. In urodynamic studies, bladder sphincter dysynergia was 7.7%, low bladder compliance with 61.5%, phasic or terminal detrusor overactivity 84.6% with 38.5% dangerous. In ultrason, they were 23.1% fight bladder with urinary retrogress and two children had dilatation of upper urinary tract and end stage renal disease, in list for renal transplantation.
摩洛哥脊柱裂的神经-泌尿学监测
目的:脊柱裂是美国儿童致残的首要原因之一。据估计,这一发病率为每10000名居民3.5人。在法国,这一比例最高,每1000名居民中有0.5人。神经外科和泌尿外科的进步使脊柱裂的死亡率真正降低。方法:对2013年1月至2015年12月在卡萨布兰卡医院物理医学科就诊的脊柱裂患儿进行回顾性描述性分析研究。结果:随访26例。平均年龄为11.9±5.8岁。其中尿频占100%,尿失禁占65.4%,尿急占73.1%,间歇流或训练占46.2%,尿后明显残留占26.9%。尿动力学研究中,膀胱括约肌增效障碍占7.7%,膀胱顺应性低占61.5%,相性或终末逼尿肌过度活动占84.6%,其中38.5%为危险。在肾移植患者中,23.1%为膀胱搏动伴尿路退行,2例为上尿路扩张伴终末期肾病。
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