One Case of a Patient with Spinal Bifida on Whom Urinary Management, Simultaneous with Periodontal Treatment, is Being Performed under General Anesthesia on a Six-monthly Basis

Spinal bifida is one of the possible congenital neural tube defects that occur for some reason when the vertebrae fail to form completely during embryological development in the womb. Symptoms differ according to the patient, with excretory disorders caused by bladder and rectal disturbances and hydrocephalus observed.<br>This report describes a spina bifida patient who requires urinary management under general anesthesia on a six-monthly basis at our hospital, simultaneously receiving periodontal treatment during the regular procedures performed under general anesthesia.<br>The patient is a 33-year-old male. A right nephrostomy tube, a left ureteral catheter, and a vesical fistula had been placed in the patient in response to renal failure caused by neurogenic bladder dysfunction as a result of spina bifida. The patient also suffers from mental retardation and due to his inability to communicate, he is hospitalized in our medical facility’s urology department every six months where he undergoes treatment to have his ureteral catheter replaced while under general anesthesia.<br>He was receiving oral health care at a separate medical facility；however, he was unable to undergo adequate treatment as an outpatient. Since the patient was found to have a considerable buildup of dental tartar, he was introduced to our hospital’s Department of Dentistry and Oral Surgery in April 2014 in order to remove the dental tartar under general anesthesia. At the request of his mother, he has since been admitted a total of four times to undergo basic periodontal treatment at the same time as having his ureteral catheter replaced while under general anesthesia.<br>It has been reported that regular maintenance under general anesthesia is beneficial for people with intellectual disabilities. It is thought that for patients who require procedures under general anesthesia on a regular basis for life support due to systemic disorders, it would also be useful to perform dental treatment simultaneously. However, in such cases, it is imperative that there is understanding, cooperation, and coordination amongst those involved with patients including their caregivers, physicians from other departments, as well as nursing staff.