Peripheral neurology as a predictor of bladder dysfunction in congenital neuropathic bladder.

Urodynamic findings and peripheral neurology were correlated in 62 patients with myelomeningocele. The primary motor and sensory levels bore no relation to bladder dysfunction. The ano-cutaneous reflex was a useful predictor, in that where the reflex was positive there was likely to be detrusor hyper-reflexia, a competent bladder neck and absence of sphincter weakness leakage. Where the reflex was absent, detrusor hyper-reflexia was absent or mild, the bladder neck usually incompetent and sphincter weakness leakage common. (Detrusor compliance could not be predicted from peripheral neurological findings). We consider the ano-cutaneous reflex to be a useful indication of bladder dysfunction and urodynamic studies are often unnecessary when it is positive.