Bowel and Bladder Continenece Among Children with Spina Bifida: A retrospective Study

Aim 1:

To empirically assess the range of continence treatments and outcomes for children with spina bifida receiving usual care from an established multidisciplinary SB clinic.

1a.

Given usual care practices at Kennedy Krieger Institute (KKI), to determine the percentage of individuals with SB who achieve partial/complete bowel and bladder continence, and to compare the effectiveness of usual care at KKI to published percentages for similar populations.

1b.

To evaluate the physiologic, medical, surgical, individual, family and environmental factors that contribute to bowel and bladder continence in children with SB.

A retrospective chart review will be conducted to address this aim. We will review a consecutive sample of one hundred medical records of children with SB ages 5 through 17 years of age who have been seen in the KKI SB clinic over the past 3 years. Records will be screened for subject eligibility prior to inclusion; exclusion criteria include children: (1) less than 5 years old or greater than or equal to 18 years of age at time of last visit and (2) history of bladder or cloacal exstrophy, or sacral agenesis/caudal regression. Clinical data from 100 child participants and their parent dyads will be abstracted from the child's medical records and entered into a research database. Data to be collected includes child and parent demographics, medical and surgical history, clinical neurological functioning, neuropsychological parameters, bowel and bladder management regimen, and assessment of continence. The data will be analyzed to describe the range of continence outcomes for children with SB receiving usual care at Kennedy Krieger Institute and to evaluate the physiologic, medical, surgical, individual, family and environmental factors that contribute to bowel and bladder continence in children with SB.