Urodynamic Evaluation in Patients with Anorectal Malformation: According to Spinal Cord Abnormalities

Abstract

Purpose: Anorectal malformation (ARM) is often accompanied by spinal cord abnormality or neurovesical dysfunction. However, only a few studies have comparatively assessed spinal cord abnormality and urodynamic data. We evaluated the effect of spinal cord abnormalities on perioperative neurovesical dysfunction and investigated the necessity of urodynamic study in patients with ARM. Materials and Methods: From 1993 to 2007, 219 patients with ARM were newly diagnosed at our institution; A retrospective study was conducted on 20 patients who underwent preoperative and postoperative urodynamic examinations. Results: Of 20 patients, 10 had abnormal spinal cords. Fourteen (70%) presented abnormal urodynamic findings (detrusor overactivity, dysfunctional voiding, detrusor sphincter dyssynergia, combined overactivity and dyssynergia, or detrusor acontractility). Preoperative urodynamic abnormalities were reported in 6 of 10 patients with abnormal spinal cords and 8 of 10 patients with normal spinal cords. New postoperative urodynamic abnormalities were reported in 2 patients in the abnormal spinal cord group, while 2 preoperative cases were resolved. In the normal spinal cord group, 2 preoperative cases were converted to other forms of urodynamic abnormality. Conclusions: We advocate routine preoperative and follow-up urodynamic assessment of all patients with anorectal malformation, regardless of spinal cord abnormality.