From 1980 to 1996 we followed up 65 children with occult spinal dysraphism (OSD) out
of 85 observed in our urodynamic laboratory. The average age at diagnosis was 4.7
years (range: 1- 21 years). In 19 cases (22%) the OSD was associated with anorectal
anomalies (ARA). Urinary incontinence or voiding anomalies with urinary tract infection
were the presenting symptom in 34 children (49%). At diagnosis all children underwent
complete neuro-urological and urodynamic evaluation. Thirty-eight patients underwent
neurosurgical correction. Vesicoureteral reflux (VUR) was present or developed in
17 patients: 15 underwent endoscopic procedures and 2 required surgery; 2 needed bladder
augmentation because of upper tract and renal function deterioration. Urinary incontinence
was treated mainly by intermittent catheterization and anticholinergic drugs, but
endoscopic treatment was performed in 3 children. At long-term follow-up (2 to 14
years), socially acceptable continence was achieved in 78% of 57 children (8 could
not be assessed because they were less than 4 years old). Upper urinary tract deterioration
occurred in 15% and renal failure in 7.5 %.
Occult spinal dysraphism - Bladder dysfunction - Neurogenic bladder
