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Restitution of Continence in Spina Bifida: The Tethered Cord Syndrome

Restitution of Continence in Spina Bifida: The Tethered Cord Syndrome Abstract Persons born with any of the types of the congenital anomaly of spina bifida can present urological problems similar to those seen in paraplegics, where the etiology may be tumor, trauma, or infection. Although many varieties of spina bifida exist, it is in the more extensive types, meningomyelocele and myelocele, that the neurologic deficit seriously compromise vesical and rectal continence. Despite orthopedic and neurosurgical successes in the early repair of such deformities and in rehabilitative therapy, little if any advance has been noted consequent to therapeutic attacks upon urinary and fecal incontinence. There has been additionally, in many instances, a gradual deterioration of the upper urinary tracts, a waning of function, and a progressive dilatation of collecting components. In the face of the seeming hopelessness of the urological situation in these patients, reevaluation of the occasional startling success attending sacral exploration of meningomyeloceles repaired at birth (wherein denudation of the References 1. Emmett, J., in Urology , edited by M. F. Campbell, Philadelphia, W. B. Saunders Company, 1954. 2. Alexander, E.; Garvey, F. K., and Boyce, W.: Congenital Lumbosacral Myelomeningocele with Incontinence: A Contribution to the Understanding of Bladder Physiology , J. Neurosurg. 11:183-191, 1954.Crossref 3. Learmonth, J. R.: Contribution to Neurophysiology of Urinary Bladder in Man , Brain 54:147-176, 1931.Crossref 4. Morales, P. A.; Deaver, G. G., and Hotchkiss, R. S.: Urological Complications of Spina Bifida in Children , J. Urol. 75:537-550, 1956. 5. Watkins, K. H.: The Bladder Function in Spinal Injury , Brit. J. Surg. 23:734-759, 1936.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

Restitution of Continence in Spina Bifida: The Tethered Cord Syndrome

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Publisher
American Medical Association
Copyright
Copyright © 1957 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1957.01280090036007
Publisher site
See Article on Publisher Site

Abstract

Abstract Persons born with any of the types of the congenital anomaly of spina bifida can present urological problems similar to those seen in paraplegics, where the etiology may be tumor, trauma, or infection. Although many varieties of spina bifida exist, it is in the more extensive types, meningomyelocele and myelocele, that the neurologic deficit seriously compromise vesical and rectal continence. Despite orthopedic and neurosurgical successes in the early repair of such deformities and in rehabilitative therapy, little if any advance has been noted consequent to therapeutic attacks upon urinary and fecal incontinence. There has been additionally, in many instances, a gradual deterioration of the upper urinary tracts, a waning of function, and a progressive dilatation of collecting components. In the face of the seeming hopelessness of the urological situation in these patients, reevaluation of the occasional startling success attending sacral exploration of meningomyeloceles repaired at birth (wherein denudation of the References 1. Emmett, J., in Urology , edited by M. F. Campbell, Philadelphia, W. B. Saunders Company, 1954. 2. Alexander, E.; Garvey, F. K., and Boyce, W.: Congenital Lumbosacral Myelomeningocele with Incontinence: A Contribution to the Understanding of Bladder Physiology , J. Neurosurg. 11:183-191, 1954.Crossref 3. Learmonth, J. R.: Contribution to Neurophysiology of Urinary Bladder in Man , Brain 54:147-176, 1931.Crossref 4. Morales, P. A.; Deaver, G. G., and Hotchkiss, R. S.: Urological Complications of Spina Bifida in Children , J. Urol. 75:537-550, 1956. 5. Watkins, K. H.: The Bladder Function in Spinal Injury , Brit. J. Surg. 23:734-759, 1936.Crossref

Journal

A.M.A. Archives SurgeryAmerican Medical Association

Published: Mar 1, 1957

References