{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:18:19Z","timestamp":1787671099489,"version":"build-2736575974"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,10,12]],"date-time":"2018-10-12T00:00:00Z","timestamp":1539302400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>To assess the relative risks of pelvic organ prolapse (POP) and urinary complications in adult spina bifida patients with neurogenic acontractile detrusor voiding with Valsalva versus those using clean\u2010intermittent catheterization (CIC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective analysis including all spina bifida patients with neurogenic acontractile detrusor with a minimum follow\u2010up of 12 months. Patients were then divided in two groups according to their bladder management: voiding with Valsalva versus CIC. The primary endpoint was any de novo or worsened rectal and\/or pelvic organ prolapse (POP) diagnosed during follow\u2010up. The secondary outcome was urinary complications defined as febrile urinary tract infections (UTI) and\/or urolithiasis and\/or renal failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010five patients (50.9% were males) met the inclusion\/exclusion criteria: 28 voiding with Valsalva and 27 performing CIC. At baseline, the rates of vaginal prolapse (44.4% vs 50%; <jats:italic>P<\/jats:italic>\u2009=\u20090.99), and rectal prolapse\/intussusception (25.9% vs 21.4%; <jats:italic>P<\/jats:italic>\u2009=\u20090.76) were similar in both groups. After a median follow\u2010up of 80.6 and 65.6 months, respectively (<jats:italic>P<\/jats:italic>\u2009=\u20090.29), the rate of de novo or worsened rectal prolapse\/intussusception was higher in the Valsalva voiding group than in the CIC group (32.1% vs 3.7%; <jats:italic>P<\/jats:italic>\u2009=\u20090.01). De novo or worsened vaginal prolapses were also more common in the Valsalva voiding group, but it did not reach statistical significance (33.3% vs 11.1%; <jats:italic>P<\/jats:italic>\u2009=\u20090.29).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Valsalva voiding might be harmful in adult spina bifida patients with neurogenic acontractile detrusor as it may increase the risk of rectal prolapse\/intussusception. Overall, the prevalence of POP and rectal prolapse was high in both groups.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.23844","type":"journal-article","created":{"date-parts":[[2018,10,12]],"date-time":"2018-10-12T11:58:29Z","timestamp":1539345509000},"page":"269-277","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Risk of prolapse and urinary complications in adult spina bifida patients with neurogenic acontractile detrusor using clean intermittent catheterization versus Valsalva voiding"],"prefix":"10.1002","volume":"38","author":[{"given":"Mehdi","family":"El Akri","sequence":"first","affiliation":[{"name":"Service d'urologie CHU Rennes Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7354-6301","authenticated-orcid":false,"given":"Charl\u00e8ne","family":"Brochard","sequence":"additional","affiliation":[{"name":"Service de Gastro\u2010Ent\u00e9rologie CHU Rennes Rennes France"},{"name":"Centre de R\u00e9f\u00e9rence Spina Bifida CHU Rennes Rennes France"},{"name":"Equipe Th\u00e9matique INPHY CIC 1414 et INSERM UMR 991 CHU Rennes Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliette","family":"Hascoet","sequence":"additional","affiliation":[{"name":"Service d'urologie CHU Rennes Rennes France"},{"name":"Centre de R\u00e9f\u00e9rence Spina Bifida CHU Rennes Rennes France"},{"name":"Equipe Th\u00e9matique INPHY CIC 1414 et INSERM UMR 991 CHU Rennes Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magali","family":"Jezequel","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence Spina Bifida CHU Rennes Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quentin","family":"Alimi","sequence":"additional","affiliation":[{"name":"Service d'urologie CHU Rennes Rennes France"},{"name":"Centre de R\u00e9f\u00e9rence Spina Bifida CHU Rennes Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zine\u2010eddine","family":"Khene","sequence":"additional","affiliation":[{"name":"Service d'urologie CHU Rennes Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Richard","sequence":"additional","affiliation":[{"name":"Service d'urologie CHU Rennes Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Bonan","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence Spina Bifida CHU Rennes Rennes France"},{"name":"Service de M\u00e9decine Physique et R\u00e9adaptation CHU Rennes Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques","family":"Kerdraon","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence Spina Bifida CHU Rennes Rennes France"},{"name":"Centre de R\u00e9\u00e9ducation de Kerpape Ploemeur France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Gam\u00e9","sequence":"additional","affiliation":[{"name":"D\u00e9partement d'Urologie Transplantation R\u00e9nale et Andrologie CHU Rangueil Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Manunta","sequence":"additional","affiliation":[{"name":"Service d'urologie CHU Rennes Rennes France"},{"name":"Centre de R\u00e9f\u00e9rence Spina Bifida CHU Rennes Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Siproudhis","sequence":"additional","affiliation":[{"name":"Service de Gastro\u2010Ent\u00e9rologie CHU Rennes Rennes France"},{"name":"Centre de R\u00e9f\u00e9rence Spina Bifida CHU Rennes Rennes France"},{"name":"Equipe Th\u00e9matique INPHY CIC 1414 et INSERM UMR 991 CHU Rennes Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8157-2825","authenticated-orcid":false,"given":"Benoit","family":"Peyronnet","sequence":"additional","affiliation":[{"name":"Service d'urologie CHU Rennes Rennes France"},{"name":"Centre de R\u00e9f\u00e9rence Spina Bifida CHU Rennes Rennes France"},{"name":"Equipe Th\u00e9matique INPHY CIC 1414 et INSERM UMR 991 CHU Rennes Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,10,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)17445-X"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1166-7087(07)92329-5"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0048399"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.07.071"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1072411"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.20230"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.07.071"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.23581"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1994.tb13081.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003081-197212000-00020"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.30.12.1737"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2007.11.100"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1159\/000052421"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.10066"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000892"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02236639"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02050307"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199603010-00015"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0b013e3181c1ede3"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrurol.2014.156"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jviscsurg.2016.10.004"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2009.01891.x"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2012.03183.x"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2016.06.026"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2015.07.086"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.20858"}],"container-title":["Neurourology and Urodynamics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fnau.23844","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.23844","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T11:33:08Z","timestamp":1694345588000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/nau.23844"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,12]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,1]]}},"alternative-id":["10.1002\/nau.23844"],"URL":"https:\/\/doi.org\/10.1002\/nau.23844","archive":["Portico"],"relation":{},"ISSN":["0733-2467","1520-6777"],"issn-type":[{"value":"0733-2467","type":"print"},{"value":"1520-6777","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,12]]},"assertion":[{"value":"2018-05-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-09-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}