Treatment of neurogenic bladder secondary to myelomeningocele based on the urodynamic status with intermittent catheterization associated with drugs. Preliminary results

: The follow-up of 36 children with neurogenic urinary bladder, aged from 3.5 months to 12 years is reported. The were serially evaluated with tonometry of detrusor muscle and urethral sphincter. Management consisted in drugs (anticholinergics, alpha-adrenergic agonists and antagonists) associated with intermittent vesical catheterization in different combinations determined by starting urodynamic measurements. With this treatment control of micturition or frank improvement was reached in 91.6% of patients, urodynamic explorations normalized or improved in 94.3% and recurrent urinary infections persisted only in 13.8%. At the view of these results authors believe that treatment of neurogenic bladder secondary to myelodysplasia must be closely dependent on previous urodynamic evaluation.