Early Vs. Expectant Management of Spina Bifida Patients-Are We All Talking About a Risk Stratified Approach?

Angelena B Edwards; Micah Jacobs

doi:10.1007/s11934-019-0943-z

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Early Vs. Expectant Management of Spina Bifida Patients-Are We All Talking About a Risk Stratified Approach?

Journal article

Peer reviewed

Early Vs. Expectant Management of Spina Bifida Patients-Are We All Talking About a Risk Stratified Approach?

Angelena B Edwards and Micah Jacobs

Current urology reports, Vol.20(11), pp.76-76

11/16/2019

DOI: 10.1007/s11934-019-0943-z

PMID: 31734847

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Abstract

Advancements in the care of patients affected by myelomeningocele have flourished in recent years especially with respect to renal preservation and continence. Involvement of urologists both prenatally and early in life has driven many developments in preventative care and early intervention. As of yet, however, the ideal management algorithm that offers these patients the least invasive diagnostic testing and interventions while still preserving renal and bladder function remains ill defined. In a shift from prior years where the use of surgical intervention and intermittent catheterization were more liberally employed, some providers have more recently advocated for monitoring patients in a more conservative manner with a variety of diagnostic tests until radiographic or clinical changes are discovered. The criteria used to define the need for catheterization and the timing to initiate CIC or more invasive interventions is disparate across pediatric urology and there is published data to support several approaches. This review presents some of these criteria for use of CIC and some newer evidence to support different approaches along with supporting the trend toward individualized medicine and use of risk stratification in developing clinical treatment algorithms.

Humans

Intermittent Urethral Catheterization

Kidney - physiopathology

Risk Assessment

Spinal Dysraphism - complications

Spinal Dysraphism - surgery

Spinal Dysraphism - therapy

Urinary Bladder, Neurogenic - etiology

Urinary Bladder, Neurogenic - physiopathology

Watchful Waiting

Details

Title: Subtitle: Early Vs. Expectant Management of Spina Bifida Patients-Are We All Talking About a Risk Stratified Approach?
Creators: Angelena B Edwards - The University of Texas Southwestern Medical Center
Micah Jacobs - The University of Texas Southwestern Medical Center
Resource Type: Journal article
Publication Details: Current urology reports, Vol.20(11), pp.76-76
DOI: 10.1007/s11934-019-0943-z
PMID: 31734847
ISSN: 1527-2737
eISSN: 1534-6285
Language: English
Date published: 11/16/2019
Academic Unit: Stead Family Department of Pediatrics; Urology
Record Identifier: 9984320061402771

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7 Times Cited - Web of Science

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