Clinical Evaluation of the Condition of Symptomatic Lower Urinary Tract Dysfunction in Sacral Agenesis

Abstract

From a urologic perspective, SA has an association with neurogenic bladder dysfunction (80%). However, the level of skeletal and spinal bony defect does not necessarily predict the severity or type of lower urinary tract dysfunction. Thus, patients merit formal evaluation, including a neurologic and urodynamic assessment at diagnosis, as such studies guide initial and long-term management. Although more recent reports have provided insight with long-term follow-up in SA patients, little has been reported regarding the stability, or lack thereof, of the neurogenic component of the lower urinary tract and long-term renal function. Hence present study was planned for clinical evaluation of the condition of symptomatic lower urinary tract dysfunction in sacral agenesis.The present study was planned in the Department of UrologyHanumantHospital,Bhavnagar Gujarat and Kurji Holy Family Hospital, Patna, Bihar, India. The study was performed from the Jan 2016 to Dec 2018. Patients with symptomatic isolated Sacral agenesis (SA), those having SA along with other obvious anomalies of caudal regression syndrome, and those with ARM or cloaca without SA were analyzed and compared.The data generated from the present study concludes that Isolated SA is an uncommon cause for neurogenic bladder that often presents late and may result in renal damage. Careful examination and plain radiograph of the spine in children with unexplained lower urinary tract symptoms may enable early identification. Severity of the bony abnormality does not correlate with severity of lower tract abnormalities and once identified, all patients should undergo formal urological and neurological assessment.

Keywords: Symptomatic Lower Urinary Tract Dysfunction, Sacral Agenesis, neurogenic bladder dysfunction, etc.