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Spinal dysraphism consist of congenital malformations resulting of abnormalities in the formation of neural tube and/or surrounding structures during embryogenesis. The aim of this study is to assess if there are specific clinical and paraclinical patterns of pelvic (urinary, bowel, sexual) disorders depending on the dysraphism's type and level of injury.
This description will help to determine a prognosis on symptoms and the risk of complication depending on the dysraphism's type and level of injury. It will provide targeted evaluation and cares: identifying patients who will be at risk of complications and needing acute monitoring or preventing cares on the symptoms' onset.
Pelvic disorders have an important impact on morbi-mortality (urinary dysfunction is the first cause of mortality in adults by renal failure or infection) and also on patients' quality of life.
Spinal dysraphism consist of congenital malformations resulting of abnormalities in the formation of neural tube and/or surrounding structures during embryogenesis. The aim of this study is to assess if there are specific clinical and paraclinical patterns of pelvic (urinary, bowel, sexual) disorders depending on the dysraphism's type and level of injury.
This description will help to determine a prognosis on symptoms and the risk of complication depending on the dysraphism's type and level of injury. It will provide targeted evaluation and cares: identifying patients who will be at risk of complications and needing acute monitoring or preventing cares on the symptoms' onset.
Pelvic disorders have an important impact on morbi-mortality (urinary dysfunction is the first cause of mortality in adults by renal failure or infection) and also on patients' quality of life.
This is an observational descriptive study with prospective inclusions of patients over 18 years old with spinal dysraphism, evaluated for urinary, anorectal, sexual dysfunctions in a one-day hospitalization.
Inclusions will be recorded during this one-day hospitalization. On this day, patients will have a medical consultation and data concerning medical history, treatments, pelvic disorders' characteristics and physical examination will be recorded. They will answer questionnaires on pelvic dysfunctions, quality of life, anxiety and depression, cognitive disorders and self-catheterizations' adherence or difficulties. They will also undergo urodynamics. In case of peripheral neurological pattern, a perineal electrophysiology will be done with recording of bulbocavernosus reflex latency and somatosensory evoked potentials.
Outpatient examinations (urinary ultrasound, urethrocystography, anorectal manometry, defecography blood test with serum creatinine, glycemia, TSH, lipids) will be collected at the next consultation.
Patients' participation will last 12 months maximum (time period between the one-day hospitalization (inclusion) and the follow up consultation where the outpatients' examinations results will be recorded).
A better understanding of pelvic dysfunctions, according to neurological systematization and type of spinal dysraphism, will help to focus the evaluation and therapeutic managements on patients with spinal dysraphism at risk of uronephrological complications.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| patient with spinal dysraphism |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Individualisation of uronephrological complications risk factors | Other | description of pelvic disorders in terms of clinical presentation, electrophysiology/urodynamics/anorectal manometry patterns, urethrocystography/urinary ultrasound/defecography results and urinary complications (infections, vesicoureteral reflux), depending on the dysraphim's type and level of injury and to correlate these parameters to the uronephrological risk factors and complications recorded. |
| Measure | Description | Time Frame |
|---|---|---|
| sexual dysfunctions in term of spinal dysraphisms | Sexual dysfonctions according the scale Men Health Sexual Questionnaire (MHSQ) score between 5 to 125 (no problem) | 1 day |
| patient quality of life | questionnaire "Qualiveen" (quality of life linked to health) to be completed by patient (score between 0 (no problem) to 4) | 1 day |
| Urinary disorders | Urinary Symptom Profile (USP) questionnaire (score between 0 (no problem) to 39) | 1 day |
| cognitive disorders | Montreal Cognitive Assessment (MOCA) scale (score between 0 to 30, normal between >=26) | 1 day |
| pelvic disorders description thanks to exams | urinary echography, anorectal manometry and defecography will be performed in order to described pelvic disorders n. | 1 day |
| Measure | Description | Time Frame |
|---|---|---|
| urinary complications | number of infections, vesicoureteral reflux | 1 day |
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Inclusion Criteria:
Exclusion Criteria:
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Men and women over 18 years old with spinal dysraphism
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Maelys Teng, MD, MSc | Contact | 0156017954 | maelys.teng@aphp.fr | |
| Claire Hentzen, MD, MSc | Contact | 0156017954 | +33 | claire.hentzen@aphp.fr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tenon hospital | Recruiting | Paris | 75020 | France |
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| ID | Term |
|---|---|
| D016135 | Spinal Dysraphism |
| D007410 | Intestinal Diseases |
| D012735 | Sexual Dysfunction, Physiological |
| ID | Term |
|---|---|
| D009436 | Neural Tube Defects |
| D009421 | Nervous System Malformations |
| D009422 | Nervous System Diseases |
| D000013 | Congenital Abnormalities |
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|
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D005767 | Gastrointestinal Diseases |
| D004066 | Digestive System Diseases |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |