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Case 65

Spina bifida and neurogenic bladder

A young adult with recurrent urinary tract infections

This is a film from a micturating cystogram.

Findings

The film demonstrates an abnormal cone shaped bladder with multiple diverticula, and reflux into the left ureter. This appearance suggests a neurogenic bladder with bladder outflow obstruction due to failure of the urethral sphincter to relax during micturition.

The cause for the neurogenic bladder is also apparent on the film; there is widening of the posterior elements of the sacrum due to the presence of spina bifida and a myelomeningocoele. The patient was known to have spina bifida and had had urinary problems since birth.

Diagnosis

Spina bifida and neurogenic bladder

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