Management of neurogenic bladder dysfunction secondary to myelomeningocele.

We investigated 55 children, aged from 24 months to 14 years with neurogenic bladder dysfunction secondary to myelomeningocele, by serial urodynamic. They were serially evaluation over 2-5 years. Management consisted of drug therapy together with intermittent vesical catheterization in different combinations on the basis of initial urodynamic assessment. In 5 children with a hypotonic sphincter, it was necessary to implant an artificial sphincter. With this regimen control or frank improvement of micturition was achieved in 53 patients, urodynamic function became normal or improved in 54, and recurrent urinary tract infections persisted only in 5 patients. In the light of these results, we believe that treatment of the neurogenic bladder secondary to myelomeningocele should be determined by initial urodynamic evaluation.