Skip to main content

Advertising Disclaimer »

Main menu

  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors/Reviewers
    • Submit Manuscript
    • Author Guidelines
    • Reviewer Guidelines
    • Open Access
    • Editorial Policies
  • Content
    • Current Issue
    • Online First
    • Archive
    • Blogs
    • Topic/Program Collections
    • AAP Meeting Abstracts
  • Pediatric Collections
    • COVID-19
    • Racism and Its Effects on Pediatric Health
    • More Collections...
  • AAP Policy
  • Supplements
  • Multimedia
    • Video Abstracts
    • Pediatrics On Call Podcast
  • Subscribe
  • Alerts
  • Careers
  • Other Publications
    • American Academy of Pediatrics

User menu

  • Log in
  • My Cart

Search

  • Advanced search
American Academy of Pediatrics

AAP Gateway

Advanced Search

AAP Logo

  • Log in
  • My Cart
  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors/Reviewers
    • Submit Manuscript
    • Author Guidelines
    • Reviewer Guidelines
    • Open Access
    • Editorial Policies
  • Content
    • Current Issue
    • Online First
    • Archive
    • Blogs
    • Topic/Program Collections
    • AAP Meeting Abstracts
  • Pediatric Collections
    • COVID-19
    • Racism and Its Effects on Pediatric Health
    • More Collections...
  • AAP Policy
  • Supplements
  • Multimedia
    • Video Abstracts
    • Pediatrics On Call Podcast
  • Subscribe
  • Alerts
  • Careers

Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Article

Bladder Function After Fetal Surgery for Myelomeningocele

John W. Brock, Michael C. Carr, N. Scott Adzick, Pamela K. Burrows, John C. Thomas, Elizabeth A. Thom, Lori J. Howell, Jody A. Farrell, Mary E. Dabrowiak, Diana L. Farmer, Earl Y. Cheng, Bradley P. Kropp, Anthony A. Caldamone, Dorothy I. Bulas, Susan Tolivaisa, Laurence S. Baskin and for the MOMS Investigators
Pediatrics October 2015, 136 (4) e906-e913; DOI: https://doi.org/10.1542/peds.2015-2114
John W. Brock III
Departments of aUrology, and
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michael C. Carr
bDivision of Pediatric Urology, and
cPerelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
N. Scott Adzick
dCenter for Fetal Diagnosis and Treatment, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Pamela K. Burrows
eThe Biostatistics Center, George Washington University, Washington, District of Columbia;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
John C. Thomas
Departments of aUrology, and
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Elizabeth A. Thom
eThe Biostatistics Center, George Washington University, Washington, District of Columbia;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Lori J. Howell
dCenter for Fetal Diagnosis and Treatment, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jody A. Farrell
fDepartment of Surgery, Benioff Children’s Hospital, and
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Mary E. Dabrowiak
gPediatric Surgery/Fetal Center, Vanderbilt University Medical Center, Nashville, Tennessee;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Diana L. Farmer
fDepartment of Surgery, Benioff Children’s Hospital, and
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Earl Y. Cheng
hLurie Children’s Hospital and Northwestern University, Chicago, Illinois;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Bradley P. Kropp
iDepartment of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Anthony A. Caldamone
jDivision of Urology, Warren Alpert Medical School of Brown University, Providence, Rhode Island;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Dorothy I. Bulas
kDepartment of Diagnostic Imaging and Radiology, Children’s National Medical Center, Washington, District of Columbia; and
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Susan Tolivaisa
lPregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Laurence S. Baskin
mDepartment of Urology, University of California, San Francisco, San Francisco, California;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • Comments
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Download PDF

Abstract

BACKGROUND: A substudy of the Management of Myelomeningocele Study evaluating urological outcomes was conducted.

METHODS: Pregnant women diagnosed with fetal myelomeningocele were randomly assigned to either prenatal or standard postnatal surgical repair. The substudy included patients randomly assigned after April 18, 2005. The primary outcome was defined in their children as death or the need for clean intermittent catheterization (CIC) by 30 months of age characterized by prespecified criteria. Secondary outcomes included bladder and kidney abnormalities observed by urodynamics and renal/bladder ultrasound at 12 and 30 months, which were analyzed as repeated measures.

RESULTS: Of the 115 women enrolled in the substudy, the primary outcome occurred in 52% of children in the prenatal surgery group and 66% in the postnatal surgery group (relative risk [RR]: 0.78; 95% confidence interval [CI]: 0.57–1.07). Actual rates of CIC use were 38% and 51% in the prenatal and postnatal surgery groups, respectively (RR: 0.74; 95% CI: 0.48–1.12). Prenatal surgery resulted in less trabeculation (RR: 0.39; 95% CI: 0.19–0.79) and fewer cases of open bladder neck on urodynamics (RR: 0.61; 95% CI: 0.40–0.92) after adjustment by child’s gender and lesion level. The difference in trabeculation was confirmed by ultrasound.

CONCLUSIONS: Prenatal surgery did not significantly reduce the need for CIC by 30 months of age but was associated with less bladder trabeculation and open bladder neck. The implications of these findings are unclear now, but support the need for long-term urologic follow-up of patients with myelomeningocele regardless of type of surgical repair.

  • Accepted July 29, 2015.
  • Copyright © 2015 by the American Academy of Pediatrics

Individual Login

Log in
You will be redirected to aap.org to login or to create your account.

Institutional Login

via Institution

You may be able to gain access using your login credentials for your institution. Contact your librarian or administrator if you do not have a username and password.

Log in through your institution

If your organization uses OpenAthens, you can log in using your OpenAthens username and password. To check if your institution is supported, please see this list. Contact your library for more details.

Purchase access

You may purchase access to this article. This will require you to create an account if you don't already have one.

Offer Reprints

PreviousNext
Back to top

Advertising Disclaimer »

In this issue

Pediatrics
Vol. 136, Issue 4
1 Oct 2015
  • Table of Contents
  • Index by author
View this article with LENS
PreviousNext
Email Article

Thank you for your interest in spreading the word on American Academy of Pediatrics.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Bladder Function After Fetal Surgery for Myelomeningocele
(Your Name) has sent you a message from American Academy of Pediatrics
(Your Name) thought you would like to see the American Academy of Pediatrics web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Request Permissions
Article Alerts
Log in
You will be redirected to aap.org to login or to create your account.
Or Sign In to Email Alerts with your Email Address
Citation Tools
Bladder Function After Fetal Surgery for Myelomeningocele
John W. Brock, Michael C. Carr, N. Scott Adzick, Pamela K. Burrows, John C. Thomas, Elizabeth A. Thom, Lori J. Howell, Jody A. Farrell, Mary E. Dabrowiak, Diana L. Farmer, Earl Y. Cheng, Bradley P. Kropp, Anthony A. Caldamone, Dorothy I. Bulas, Susan Tolivaisa, Laurence S. Baskin, for the MOMS Investigators
Pediatrics Oct 2015, 136 (4) e906-e913; DOI: 10.1542/peds.2015-2114

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Bladder Function After Fetal Surgery for Myelomeningocele
John W. Brock, Michael C. Carr, N. Scott Adzick, Pamela K. Burrows, John C. Thomas, Elizabeth A. Thom, Lori J. Howell, Jody A. Farrell, Mary E. Dabrowiak, Diana L. Farmer, Earl Y. Cheng, Bradley P. Kropp, Anthony A. Caldamone, Dorothy I. Bulas, Susan Tolivaisa, Laurence S. Baskin, for the MOMS Investigators
Pediatrics Oct 2015, 136 (4) e906-e913; DOI: 10.1542/peds.2015-2114
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
Print
Download PDF
Insight Alerts
  • Table of Contents

Jump to section

  • Article
    • Abstract
    • Methods
    • Results
    • Discussion
    • Conclusions
    • Acknowledgments
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
  • Comments

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Fetal surgery for spina bifida aperta
  • Google Scholar

More in this TOC Section

  • Applications of Artificial Intelligence for Retinopathy of Prematurity Screening
  • Phenobarbital and Clonidine as Secondary Medications for Neonatal Opioid Withdrawal Syndrome
  • Severe Acute Neurologic Involvement in Children With Hemolytic-Uremic Syndrome
Show more Article

Similar Articles

Subjects

  • Neurology
    • Neurology
    • Neurologic Disorders
  • Urology
    • Urology
    • Genitourinary Disorders
  • Journal Info
  • Editorial Board
  • Editorial Policies
  • Overview
  • Licensing Information
  • Authors/Reviewers
  • Author Guidelines
  • Submit My Manuscript
  • Open Access
  • Reviewer Guidelines
  • Librarians
  • Institutional Subscriptions
  • Usage Stats
  • Support
  • Contact Us
  • Subscribe
  • Resources
  • Media Kit
  • About
  • International Access
  • Terms of Use
  • Privacy Statement
  • FAQ
  • AAP.org
  • shopAAP
  • Follow American Academy of Pediatrics on Instagram
  • Visit American Academy of Pediatrics on Facebook
  • Follow American Academy of Pediatrics on Twitter
  • Follow American Academy of Pediatrics on Youtube
  • RSS
American Academy of Pediatrics

© 2021 American Academy of Pediatrics