Radiologic Investigation of the Urinary Tract in the Neonate with Myelomeningocele

Abstract

A significant number of [human] neonates with myelomeningocele are born with potentially damaging abnormalities of the urinary tract. It is logical to investigate these patients aggressively and initiate therapy as early as possible to preserve renal function and maintain lower tract integrity for future continence management. Results of excretory urograms and voiding cystourethrograms were reviewed in 68 consecutive neonates with myelomeningocele. Only 1/3 of the patients with normal excretory urograms had a normal voiding cystourethrogram; both studies should be performed for complete evaluation of the urinary tract. Of these 68 patients 55 (80.9%) had a normal excretory urogram but only 17 (30.9%) had a normal voiding cystourethrogram. Of the 13 patients (19.1%) with an abnormal excretory urogram 12 (92.3%) had an abnormal voiding cystourethrogram. Reflux occurred in 16.2% of patients; 6 of 7 patients with grade II reflux and 1 of 3 patients with grade III reflux had a normal excretory urogram.