{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T03:00:17Z","timestamp":1760238017014,"version":"build-2065373602"},"reference-count":27,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T00:00:00Z","timestamp":1658361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Higher Education (MOHE) Malaysia","award":["FRGS\/1\/2019\/SKK08\/UM\/02\/17","FRGS\/1\/2019\/SKK06\/UKM\/02\/06"],"award-info":[{"award-number":["FRGS\/1\/2019\/SKK08\/UM\/02\/17","FRGS\/1\/2019\/SKK06\/UKM\/02\/06"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>The incidence and severity of urinary tract infections (UTIs) due to spina bifida is poorly understood in Malaysia. Tethering of the spinal cord is a pathological fixation of the cord in the vertebral column that can result in neurogenic bladder dysfunction and other neurological problems. It occurs in patients with spina bifida, and the authors of this study sought to investigate the impact of untethering on the urological manifestations of children with a tethered cord, thereby consolidating a previously known understanding that untethering improves bladder and bowel function. Demographic and clinical data were collected via an online questionnaire and convenient sampling techniques were used. A total of 49 individuals affected by spina bifida participated in this study. UTIs were reported based on patients\u2019 observation of cloudy and smelly urine (67%) as well as urine validation (60%). UTI is defined as the combination of symptoms and factoring in urine culture results that eventually affects the UTI diagnosis in spina bifida individuals irrespective of CISC status. Furthermore, 18% of the respondents reported being prescribed antibiotics even though they had no history of UTI. Therefore, indiscriminate prescription of antibiotics by healthcare workers further compounds the severity of future UTIs. Employing CISC (73%) including stringent usage of sterile catheters (71%) did not prevent patients from getting UTI. Overall, 33% of our respondents reported manageable control of UTI (0\u201335 years of age). All individuals below the age of 5 (100%, n = 14) were seen to have improved urologically after the untethering surgery under the guidance of the Malaysia NTD support group. Improvement was scored and observed using KUB (Kidneys, Ureters and Bladder) ultrasound surveillance before untethering and continued thereafter. Spina bifida individuals may procure healthy bladder and bowel continence for the rest of their lives provided that neurosurgical and urological treatments were sought soon after birth and continues into adulthood.<\/jats:p>","DOI":"10.3390\/children9071090","type":"journal-article","created":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T10:36:56Z","timestamp":1658399816000},"page":"1090","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Survey on Untethering of the Spinal Cord and Urological Manifestations among Spina Bifida Patients in Malaysia"],"prefix":"10.3390","volume":"9","author":[{"given":"Singh","family":"Nisheljeet","sequence":"first","affiliation":[{"name":"Invertebrate & Vertebrate Neurobiology Lab, Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abu","family":"Azizi","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamalanathan","family":"Palaniandy","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dharmendra","family":"Ganesan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teng","family":"Ong","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azmi","family":"Alias","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tunku Abdul Rahman Neuroscience Institute (IKTAR), Hospital Kuala Lumpur, Kuala Lumpur 50586, Malaysia"},{"name":"Department of Pediatric Neurosurgery, Women and Children Hospital Kuala Lumpur, Kuala Lumpur 50586, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramalinggam","family":"Rajamanickam","sequence":"additional","affiliation":[{"name":"Faculty of Law, Universiti Kebangsaan Malaysia, Kuala Lumpur 43600, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3809-3460","authenticated-orcid":false,"given":"Wahib","family":"Atroosh","sequence":"additional","affiliation":[{"name":"Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siti","family":"Mohd-Zin","sequence":"additional","affiliation":[{"name":"Invertebrate & Vertebrate Neurobiology Lab, Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Lee-Shamsuddin","sequence":"additional","affiliation":[{"name":"Invertebrate & Vertebrate Neurobiology Lab, Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Singh","family":"Nivrenjeet","sequence":"additional","affiliation":[{"name":"Invertebrate & Vertebrate Neurobiology Lab, Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Warren","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Urology, Kuala Lumpur Hospital, Jalan Pahang, Kuala Lumpur 50586, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2447-3211","authenticated-orcid":false,"given":"Noraishah","family":"Abdul-Aziz","sequence":"additional","affiliation":[{"name":"Invertebrate & Vertebrate Neurobiology Lab, Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/j.ucl.2015.05.006","article-title":"Urinary tract infection and neurogenic bladder","volume":"42","author":"McKibben","year":"2015","journal-title":"Urol. 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