Fetal myelomeningocele repair: urologic aspects

Abstract

The notion that earlier surgical correction of congenital anomalies will lead to improved outcomes permeates throughout surgical literature. This review critically assesses some of the urologic evaluations in patients who have undergone fetal repair of their myelomeningoceles. Thus far, there are limited data to determine the effects of such a repair with respect to urologic outcome. Early data, though, have suggested that improvements are being noted in a cohort of patients who have undergone fetal repair of their myelomeningocele with respect to neurodevelopmental outcome and lower extremity neuromotor function. What remains to be seen is whether fetal surgery and the noted changes translate into long-term improvement. The efforts being put forth to critically assess the outcomes of such surgery are laudable and yet the end analysis may still leave the question unanswered.