[Prevention of renal injury by means of intermittent catheterization in children with neurogenic bladder secondary to spina bifida].

We have studied 16 children with spina bifida treated by clean intermittent catheterism (CIC) for at least four years. Those without VUR (5 patients) and those with grades I to III (7 patients) have maintained their kidneys unscared. Furthermore, VUR disappeared in some of them. In 4 children with severe VUR (grades IV and V) a Cohen ureteroneocystostomy was added, and all kept their kidneys stable. Asymptomatic bacteriuria was not modified by CIC and its' eventual relationship with the onset of scarring could not be established. Kidney damage, however, can be detected earlier by decrease of concentration capacity. Continence was obtained in only 30% of the cases, but the addition of some drugs has further improved our results after this study was concluded. CIC should be used as a first choice treatment in most patients with neurogenic bladder due to spina bifida.