Abstract
Purpose
Myelomeningocele (MMC) is one of the commonest congenital malformations. Hydrocephalus develops in 65–85% of cases with MMC. Only 3–10% of MMC patients have normal urinary continence. We aim to investigate the effects of early and late operation in MMC patients in terms of development of hydrocephalus, motor deficits, and bladder functions.
Methods
Medical records of MMC patients operated between January 2008 and December 2014 were reviewed retrospectively.
Results
We retrospectively investigated patients’ records of 43 patients. Twenty of the patients were operated within the first 48 h after the delivery (early repair group), while 23 of the patients were operated after 48 h of delivery (late repair group). In the early repair group, 15 patients were operated due to hydrocephalus. Urodynamic problems were detected in 17 (85%) patients. In the late repair group, shunts were placed in 14 (61%) patients during follow-up period and urodynamic problems were detected in 19 (82.6%) patients. Mean operation time for the late group was 4.6 months. There was no statistical difference between the early and late group in terms of neurological and urodynamic deficits. The mean follow-up period was 45.5 months.
Conclusion
In the literature, surgery in the first 48 h of life is recommended for MMC patients. There was no difference between the early- and late-operated groups by means of hydrocephalus, urodynamic functions, and motor deficits in our study. Late surgery of intact sacs may avoid complications related to surgery in the neonatal period.
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Mevlüt Özgür Taşkapılıoğlu: design of the study, writing of the manuscript; Bilge Türedi: collecting the data; Oğuz Altunyuva: collecting the data; Mehmet Mazhar Utanğaç: writing of the manuscript; Mehmet Emin Balkan and Nizamettin Kılıç: design of the study. All of the authors contributed to the critical revision of the manuscript.
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Bursa Uludag University School of Medicine institutional review board approved this study (2018-17/19).
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Taşkapılıoğlu, M.Ö., Türedi, B., Altunyuva, O. et al. Retrospective analysis of early- and late-operated meningomyelocele patients. Childs Nerv Syst 37, 539–543 (2021). https://doi.org/10.1007/s00381-020-04860-8
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DOI: https://doi.org/10.1007/s00381-020-04860-8