{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T11:01:35Z","timestamp":1785841295931,"version":"3.56.0"},"reference-count":10,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,9,12]],"date-time":"2020-09-12T00:00:00Z","timestamp":1599868800000},"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":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Since 2011 we have been following prospectively myelomeningocele patients treated in utero with particular interest to patients with sphincter weakness\/deficiency. We investigated the changes of bladder pattern and upper urinary tract with time in children who underwent in utero repair and had low\u2010pressure incontinence based on urodynamic evaluation (UE).<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>From the 120 patients in our database, 117 had at least one UE. Of these, 30 were classified as incontinent when leaking at low pressure (&lt;40\u2009cmH20). We reviewed clinical evaluation, urinary tract ultrasound, voiding cystourethrography (VCUG), and other UE parameters at first and last evaluation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found 30 cases (25.64%). Mean age at initial evaluation was 4.97 months followed by UE done initially at mean age of 5.73 months. Follow\u2010up was 28.4 months. Febrile urinary tract infection has been found in four patients (13.3%), hydronephrosis in four patients, and bladder neck thickening in three (10%). The VCUG showed vesicoureteral reflux in three cases (3\/27, 11.1%). A total of 90% of patients had detrusor overactivity with mean maximum detrusor pressure (33.37\u2009cmH20). Only 16.67% of patients showed normal bladder capacity. From the 30 patients, 23 had at least two UE. We noticed a change of bladder pattern as follows: six patients became of high\u2010risk pattern, five normal, and two with underactive bladder pattern. The average interval between the first and last UE was 25.5 months (median: 15 months).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We concluded that 43.47% of patients with low DLPP have kept the incontinent pattern. If the initial LPP was below 30\u2009cmH20, 70% remained with the incontinet pattern.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.24497","type":"journal-article","created":{"date-parts":[[2020,9,28]],"date-time":"2020-09-28T20:58:40Z","timestamp":1601326720000},"page":"2373-2378","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["In utero myelomeningocele repair: The natural history of patients with incontinent pattern (sphincteric deficiency: leakage below 40\u2009CMH20)"],"prefix":"10.1002","volume":"39","author":[{"suffix":"Jr","given":"Antonio","family":"Macedo","sequence":"first","affiliation":[{"name":"Department of Urology CACAU\u2010NUPEP  S\u00e3o Paulo S\u00e3o Paulo Brazil"},{"name":"Department of Pediatrics Federal University of S\u00e3o Paulo  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9524-6107","authenticated-orcid":false,"given":"Ricardo Del Debbio","family":"Di Migueli","sequence":"additional","affiliation":[{"name":"Department of Urology CACAU\u2010NUPEP  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9rgio","family":"Cavalheiro","sequence":"additional","affiliation":[{"name":"Departament of Neurosurgery Federal University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Santa Joana Maternity Hospital  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Moron","sequence":"additional","affiliation":[{"name":"Santa Joana Maternity Hospital  S\u00e3o Paulo S\u00e3o Paulo Brazil"},{"name":"Departament of Obstetrics\u2010Fetal Medicine Federal University of S\u00e3o Paulo  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7087-4534","authenticated-orcid":false,"given":"Marcela Leal","family":"da Cruz","sequence":"additional","affiliation":[{"name":"Department of Urology CACAU\u2010NUPEP  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,9,12]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1014379"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000000521"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2014.10.118"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11884-016-0371-6"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101705"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2014.03.041"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2010.03.080"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2018.02.021"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-2114"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.14639"}],"container-title":["Neurourology and Urodynamics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.24497","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/nau.24497","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.24497","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T01:46:17Z","timestamp":1692841577000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/nau.24497"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,12]]},"references-count":10,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1002\/nau.24497"],"URL":"https:\/\/doi.org\/10.1002\/nau.24497","archive":["Portico"],"relation":{},"ISSN":["0733-2467","1520-6777"],"issn-type":[{"value":"0733-2467","type":"print"},{"value":"1520-6777","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,12]]},"assertion":[{"value":"2020-06-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}