Q: I have a 7 years old son. He was born with myelomeningocoele and was operated. Now the problem is that he does not stop his urine and stool. Both his feet under the ankle are without sensation. The doctors say that he will die within 4-5 years due to kidney failure. He is also severely underweight. Please help and advise me.

A:Myelomeningocoele is usually associated with paralysis of both lower limbs (paraplegia) and inability to control urine (incontinence). This is due to the abnormality of the spinal cord. Although the defect can be covered with surgery, the neurological problems cannot be cured permanently with surgery or medicines. The movements of the limbs can be improved by physiotherapy even though full movements are unlikely. Enuresis can be controlled to some extent by palliative urosurgical procedures but urinary infections are likely. It can in the long run produce renal failure. In general the life span of these patients are less than normal population, but it is difficult to predict when kidney failure will occur and exactly how long the child will live. I suggest you should contact an expert physiotherapist and a paediatrician interested in developmental pediatrics for further special advice and care.