{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T13:12:31Z","timestamp":1789909951471,"version":"4.0.1"},"reference-count":36,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,10,11]],"date-time":"2013-10-11T00:00:00Z","timestamp":1381449600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2013,11]]},"abstract":"\n Objectives<\/jats:title>\n \n \n \n \n To describe the long\u2010term upper (\n UUT<\/jats:styled-content>\n ) and lower urinary tract (\n LUT<\/jats:styled-content>\n ) outcomes in patients with closed spinal dysraphism (\n CSD<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:list-item>\n \n \n CSD<\/jats:styled-content>\n differs from open spinal dysraphism (\n OSD<\/jats:styled-content>\n ) by its long asymptomatic course and consequent later diagnosis. The outcome of\n UUT<\/jats:styled-content>\n and\n LUT<\/jats:styled-content>\n function in adults with\n CSD<\/jats:styled-content>\n is relatively unknown.\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Patients and Methods<\/jats:title>\n \n \n \n \n A systematic review was performed following the standards of the\n P<\/jats:styled-content>\n referred\n R<\/jats:styled-content>\n eporting\n I<\/jats:styled-content>\n tems for\n S<\/jats:styled-content>\n ystematic\n R<\/jats:styled-content>\n eviews and\n M<\/jats:styled-content>\n eta\u2010\n A<\/jats:styled-content>\n nalyses (\n PRISMA<\/jats:styled-content>\n ) guidelines. An extensive search was made of\n P<\/jats:styled-content>\n ub\n M<\/jats:styled-content>\n ed and\n EMBASE<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:list-item>\n \n \n Included were papers on adults with any form of primary\n CSD<\/jats:styled-content>\n that described bladder and\/or kidney function. Only\n E<\/jats:styled-content>\n nglish and\n D<\/jats:styled-content>\n utch language papers were included. Excluded were papers on patients aged <18 years and patients with secondary tethered cord following childhood\n OSD<\/jats:styled-content>\n repair. International\n C<\/jats:styled-content>\n ontinence\n S<\/jats:styled-content>\n ociety terminology was used to describe\n LUT<\/jats:styled-content>\n outcomes.\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n \n \n Eventually, only seven studies (90 patients) were included and none of these described renal outcomes. Five of the seven papers were on outcomes after untethering surgery during adulthood.<\/jats:p>\n <\/jats:list-item>\n \n Urological complaints were present in 54\/79 (68.4%) patients.<\/jats:p>\n <\/jats:list-item>\n \n Urodynamic studies (48 patients available) revealed detrusor underactivity in 46.5% of the evaluated cases, detrusor overactivity in 32.6% and normal findings in 16.3% of the studied patients.<\/jats:p>\n <\/jats:list-item>\n \n Symptomatic improvement after surgery for tethered cord occurred in 33.3\u201390.0%, depending on the subgroup studied. Urodynamic improvement rates ranged from 11.1% to 54.5% (but based on three studies with only 24 patients). Success of surgery depended on the time between onset of symptoms and operation, and (sometimes) type of lesion.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n \n \n \n Few data are available on long\u2010term urological outcomes in adult patients with\n CSD<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:list-item>\n \n \n More extensive research on follow\u2010up, including the functional status of the\n UUT<\/jats:styled-content>\n , is recommended.\n <\/jats:p>\n <\/jats:list-item>\n \n \n Based upon the little evidence available, we think life\u2010long follow\u2010up (from birth into adulthood) of those with\n CSD<\/jats:styled-content>\n and neurogenic bladder is advisable.\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.12289","type":"journal-article","created":{"date-parts":[[2013,6,13]],"date-time":"2013-06-13T07:53:04Z","timestamp":1371109984000},"page":"1009-1017","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Paucity of evidence for urinary tract outcomes in closed spinal dysraphism: a systematic review"],"prefix":"10.1111","volume":"112","author":[{"given":"Paul W.","family":"Veenboer","sequence":"first","affiliation":[{"name":"Urology Rehabilitation University Medical Centre Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.L.H. 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