Registering-accuracy test.

<p>Mean and spread of the Euclidian distance of registered 3D points to the mean 3D point, per lesion.</p

Calibration-requirement test.

<p>Test to assess whether a previously obtained calibration can be loaded into the software, to avoid delay in surgery due to calibration. The accuracy did not decrease after disassembling and reassembling the cystoscopy set and target several times.</p

Phantoms.

<p>a. Is the box phantom with four lesions drawn on the inside; b. and c. are the balloon phantom with four lesions drawn inside the balloon, coupled to the trocard holder.</p

Registering-volume-influence test.

<p>Test to determine the influence of volume differences on the registering accuracy in the balloon phantom. For each measurement set per volume, the Euclidian distance between the registered 3D points and the mean registered 3D point of the 300 cc filled balloon were calculated per lesion.</p

Endoscopic balloon phantom.

<p>Views through the endoscope before and after registering lesion number 68 and 33. Note that one lesion is mirrored in the air bubble.</p

Schematic bladder navigation system.

<p>The typical position of a patient during cystoscopy or TURBT, with the legs in stirrups. The cystoscope set is connected to the light source, endoscopic camera and a tracking target (conventional, butterfly or foil) The camera sends image data to a computer that converts the analogous imaging data to digital imaging information. This is combined by a computer with positional information of the tracking target, which is read by the stereo-tracking camera. Standard endoscopic images edited with navigational directions are displayed on the monitor.</p

Results overview.

<p>All tests results are shown numerically summarized. The mean and standard deviation of the Euclidean distance to the reference positions are depicted (of every 16 registrations per lesion and per variable). The navigation tests (including the rotational-correction test) do not show a mean distance, but a percentage of the correctly navigated lesions, that were ‘on screen’ after navigation (also of every 16 navigations per lesion and variable).</p

Upper and Lower Urinary Tract Outcomes in Adult Myelomeningocele Patients: A Systematic Review

<div><h3>Background</h3><p>The introduction of sophisticated treatment of bladder dysfunction and hydrocephalus allows the majority of SB patients to survive into adulthood. However, no systematic review on urological outcome in adult SB patients is available and no follow-up schemes exist.</p> <h3>Objectives</h3><p>To systematically summarize the evidence on outcome of urinary tract functioning in adult SB patients.</p> <h3>Methods</h3><p>A literature search in PubMed and Embase databases was done. Only papers published in the last 25 years describing patients with open SB with a mean age >18 years were included. We focused on finding differences in the treatment strategies, e.g., clean intermittent catheterization and antimuscarinic drugs versus early urinary diversion, with regard to long-term renal and bladder outcomes.</p> <h3>Results</h3><p>A total of 13 articles and 5 meeting abstracts on urinary tract status of adult SB patients were found describing a total of 1564 patients with a mean age of 26.1 years (range 3–74 years, with a few patients <18 years). All were retrospective cohort studies with relatively small and heterogeneous samples with inconsistent reporting of outcome; this precluded the pooling of data and meta-analysis. Total continence was achieved in 449/1192 (37.7%; range 8–85%) patients. Neurological level of the lesion and hydrocephalus were associated with incontinence. Renal function was studied in 1128 adult patients. In 290/1128 (25.7%; range 3–81.8%) patients some degree of renal damage was found and end-stage renal disease was seen in 12/958 (1.3%) patients. Detrusor-sphincter dyssynergy and detrusor-overactivity acted as adverse prognostic factors for the development of renal damage.</p> <h3>Conclusions</h3><p>These findings should outline follow-up schedules for SB patients, which do not yet exist. Since renal and bladder deterioration continues beyond adolescence, follow-up of these individuals is needed. We recommend standardization in reporting the outcome of urinary tract function in adult SB patients.</p> </div

Renal function adult studies (MMC patients) in chronological order.

<p>AMD = antimuscarinic drugs; CKD = chronic kidney disease; N/A = not available; DOA = Detrusor overactivity; DSD = detrusor sphincter dyssynergia; ESRD = end-stage renal disease; GFR = glomerular filtration rate; LPP = leak point pressure; Mixed: occult and open SB; VUR = vesico-ureteral reflux; rUTIs = recurrent urinary tract infections; N.S. = not significant.</p>a<p>in 12/193 patients renal function was unknown;</p>b<p>no reference values of renal function;</p>c<p>no urodynamic data available;</p>e<p> <b>exemption; only median age is stated, whereas in all other studies, mean age is given.</b></p>f<p>other denominator; only studies with known CKD’s are taken into account for this figure (see Results-section for more details).</p

Survival in spina bifida patients.

<p>If ‘survival into adulthood’ is given, the exact ages were not specified in the article.</p>*<p>Patients treated before 1975.</p>†<p>Patients treated after 1975.</p>‡<p>Two different papers, same study.</p><p>N/A = not available</p