There are various tests done to diagnose and to check on bladder and kidney function that should be repeated over time as the child grows and periodically as an adult.  Urological care for individuals with SA/CRS is similar to those with spina bifida, although not exactly the same. Individuals with SA/CRS  may have characteristics that include a missing kidney while that is not the case for those with spina bifida.  A fact sheet on urological care can be downloaded from the spina bifida website, here.

The RENAL ULTRASOUND is an easy, non invasive test that uses sound waves to allows doctors to see the kidneys and bladder and ureters. It should be done yearly, after a baseline is established at 1 month of age, and then yearly. The yearly appointment checks any damage to the kidney due to repeated infections, which cause kidney scarring. Also, as the child grows, sometimes the spinal cord can become tethered.  This occurs more often with children who do  not have a blunt ending spinal cord in children with SA/CRS. Tethering occurs when scar tissue traps the cord and pulls on the end of the cord. That may impact bladder function, so a urologist can see if bladder function has changed using the ultra sound.

The voiding cystourethrogram, or VCUG, is a minimally invasive test that uses a special x-ray technology called fluoroscopy to visualize your child’s urinary tract and bladder. A VCUG can help:

• diagnose vesicoureteral reflux– a condition in which urine flows the wrong way, from the bladder back up to the kidneys
• determine why your child has recurring urinary tract infections
• discover if antibiotic treatment or anti-reflux surgery was effective
• check if there are any abnormalities or blockages of the urethra

URODYNAMICS is a bladder function tests measure how much urine the bladder can hold, the pressure within the bladder, how well urine flows, and how well the bladder empties when it is full. It includes a cystometry Special sensors may be placed on the skin near the urethra (the tube through which urine passes) or rectum to see if the muscles and nerves in those parts of the body are working properly.

The VCUG and Urodynamics are done initially to check on bladder function, and they are done when there are repeated infections, and in preparations for any surgeries as well as after surgeries to confirm that everything is going well.