Types of Spina Bifida & Urology Care By Paediatric Experts
What happens when you discover your child has spina bifida? While the diagnosis can sound overwhelming, managing spina bifida through expert-recommended treatment options is possible. For this, the first step includes understanding the types of spina bifida, its causes, and the complexity level of the symptoms. In this blog, we plan to explain all these details along with instances where seeking advice from a paediatric urologist becomes vital. Take a proactive approach for your children by implementing these tips in their wellness journey.
Worried about spina bifida?
A] Understanding Spina Bifida Through Its Types And Causes
Spina bifida is a condition often present at birth that affects the development of your spine and spinal cord. In this, the brain and spinal cord are not able to close completely. This condition is usually noticeable in the first month of pregnancy. Challenges related to movement, bladder, or bowel control can be found. Close involvement of experts such as paediatric urologists, neurosurgeons, and orthopaedics is considered a wise decision.
Causes Of Spina Bifida
While spina bifida begins in the early stage of a woman’s pregnancy, the effects can be long-lasting. While a single factor isn’t responsible, focusing on certain genetic and environmental factors has shown some interesting results.
- Genetic disposition: A history of neural tube defects significantly increases the risk of developing spina bifida.
- Nutritional deficiencies: Any deficiency of folic acid, also known as B9, is a well-known risk factor.
- Other factors: Conditions such as diabetes, obesity, or high fever experienced during early pregnancy can increase your chances of spina bifida. Overexposure to the use of saunas or hot tubs has also been linked with this condition.
Types of Spina Bifida
Understanding the different types of spina bifida helps both parents and carers to decide which type of medical intervention would best suit the child. Different types of spina bifida can be categorised based on their complexity level:
- Spina Bifida Occulta
This is the most common type of spina bifida. Spina bifida occulta symptoms are usually not easily visible. Signs such as a fatty lump on your lower back help to identify this type of spina bifida. While this type of spina bifida might not cause any trouble, concerns relating to back pain and bladder control can be reported. - Meningocele
A fluid-filled sac is often noticeable in a meningocele. Here, the protective membranes on the spinal cord push from the opening in the vertebrae. Some children may report mild neurological symptoms. Treatment options involving surgical repair might be recommended in this type of spina bifida. - Myelomeningocele
Unlike other forms, this type of spina bifida is considered quite intense. Both the spinal cord and meninges push through the spine, forming an open sac on the child’s back. The exposed nerves are what make it prone to damage easily. A collaborative effort involving neurosurgeons, paediatric urologists, physiotherapists, and orthopaedic specialists is usually required.
Note: Spina bifida cystica includes both meningocele and myelomeningocele.
B] The Connection Between Spina Bifida And Urinary Health
Unlike how people think, spina bifida isn’t just related to spinal and mobility issues. Urinary and bladder problems, for instance, are frequently reported issues. Concerns relating to emptying urine properly are often reported. If the urinary tract infection persists, it should be treated immediately to prevent further complications. The goal here is to keep the child’s best interests at the forefront. If you’re looking for a paediatric urologist who’ll treat your child’s spina bifida with precision and empathy, you can consult Dr Gursev Sandlas.
C] Spina Bifida Treatment and Surgery Options
For the treatment of spina bifida, a multidisciplinary approach might be more useful. Again, the type of spina bifida will be taken into consideration when treating spina bifida.
- Prenatal surgery
In this type of treatment option, the spinal defect is repaired before a child’s birth. This leads to improvement in both mobility and bladder functionality. This type of treatment option for spina bifida is often chosen when the chances of the child’s progression are high. - Postnatal surgery
Postnatal is usually after a child’s birth. Neurosurgeons are responsible for closing the opening in the baby’s spine, which reduces the chances of any infection. The spinal cord function is preserved, although the damage that occurred cannot be reversed. - Urological management
Advice from a paediatric urologist can be sought. Measures such as clean intermittent catheterisation and prescribing medicines are generally helpful.
Timely intervention of spina bifida with surgery, combined with rehabilitation, will surely improve their mobility.
D] How Paediatric Urologists Manage Bladder Function
Management of spina bifida without the help of an expert can be difficult. This is because a paediatric urologist can help with several issues, such as bladder control and more. Let’s look into these with more details:
- Monitoring and evaluation
Based on your condition, ultrasounds and urodynamic studies might be performed. Issues related to high blood pressure, if present, can be resolved. - Medications
Both anticholinergic medications and beta-3 agonists are commonly prescribed medicines. Only in certain cases might desmopressin be suggested. - Surgical options
If the effect of medications is not noticeable, surgical options might be the next best option. Treatment options that involve bladder augmentation, Mitrofanoff, and urinary diversion can be suggested depending on the case.
Along with these options, a holistic approach involving assistance from the parent and child will work excellently.
E] Long-Term Management of Spina Bifida and Urinary Health
Even after treatment, long-term management of spina bifida and urinary health is considered crucial.
- Regular tracking
Regular tracking will help understand any infection or kidney damage well in advance. Monitoring of these tests can be done every 6-12 months. - Prevention of UTIs
Check to see if your child is consistent with their hydration levels. If recurrent infections occur, prophylactic antibiotics can be prescribed. A regular screening process will help to avoid this in the first place. - School support
Appropriate instructions to the teachers as well as the carers can be given. This would be based on the child’s needs. Counselling, if required, can be suggested to deal with social anxiety. Encouragement in sports and other activities will help a child cope better with this condition.
With long-term management of spina bifida, a child’s ability to exercise excellent bladder control and maintain kidney function will improve even in adulthood.
F] When To Consult A Paediatric Urologist
Issues such as urinary tract infections, kidney damage or incontinence can further worsen if not taken care of. You should ideally consult a paediatric urologist when your child has:
- Difficulty with urination: Being unable to urinate properly.
- Incontinence: Frequent bedwetting episodes beyond toilet-training age.
- Recurring UTIs: Frequent UTIs can indicate reflux of urine into the kidneys.
- Difficulty with bowel functions: Any constipation or stool accidents need to be managed first.
- Changes with urination: If changes in frequency or colour are noticed, they can be discussed.
If you notice any of these signs, you can contact us to devise a personalised treatment plan for your child.
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G] Living Confidently With Spina Bifida
Living with spina bifida can feel quite overwhelming. However, the right approach can make this journey easier. Consult Dr Gursev, a paediatric surgeon and urologist with over 20 years of experience. At Dr Gursev Sandlas, we incorporate state-of-the-art diagnostic tools and minimally invasive robotic surgery in our services. Our treatment plans include CIC, bladder control and other preventive measures for long-term management of spina bifida. Beyond our medical expertise, we wish to empower children and help them look forward to a future where they live confidently.
