Abstract
The key factors in the management of the neuropathic bladder are an understanding of the pathophysiology and natural history of the bladder and urethral dysfunction, an understanding of the urodynamic investigation of such problems, and a realistic approach to treatment. Those children with good motivation, intelligence, mobility and manipulative skills can almost always be made continent by surgical means. Management otherwise is to control or contain incontinence as far as possible and to preseve upper tract function.
Similar content being viewed by others
References
Lapides J, Diokno AC, Silber SJ, Lowe BS (1972) Clean intermittent self-catheterisation in the treatment of urinary tract disease. J Urol 107: 458–461
Shapiro SR, Lebowitz R, Colodny AH (1975). Fate of 90 children with ileal conduit urinary diversion a decade later: analysis and complications, pyelography, renal function and bacteriology. J Urol 114: 289–295
Schwarz GR, Jeffs RD (1984) Ileal conduit urinary diversion in children: computer analysis of long term follow-up from 2–16 years. J Urol 114: 285–288
Elder DD, Moisey CU, Rees RWM (1979) A long term follow-up of the colonic conduit operation in children. Br J Urol 51: 462–465
Cass AS, Luxenberg M, Gleich P, Johnson CF (1984) A 22 year follow-up of ileal conduits in children with a neurogenic bladder. J Urol 132: 529–531
Bates CP, Whiteside CG, Turner-Warwick R (1970) Synchronous cine/pressure/flow cytourethrography with special references to stress and urge incontinence. Br J Urol 42: 714–723
Whiteside CG (1972) Videocystographic studies with simultaneous presure and flow recordings. Br Med Bull 28: 214–219
Mundy AR, Borzyskowski M, Saxton HM (1982) Videourodynamic evaluation of neuropathic vesicourethral dysfunction in children. Br J Urol 54: 645–649
Rickwood AMK, Thomas DG, Philp NM, Spicer RD (1982) Assessment of congenital neuropathic bladder by combined urodynamic and radiological studies. Br J Urol 54: 512–518
Raezer DM, Benson GS, Wein AJ, Dukett JW (1977) The functional approach to the management of the paediatric neuropathic bladder: a clinical study. J Urol 117: 649–653
Mundy AR, Shah PJR, Borzyskowski M, Saxton HM (1985) Sphincter behaviour in myelomeningocoele. Br J Urol 57: 647–651
Lapides J, Diokno AC, Lowe BS, Kalish MD (1974) Follow up on unsterile intermittent catheterisation. J Urol 111: 184–186
Lapides J, Diokno AC, Gould FR, Lowe BS (1976) Further observations on self catheterization. J Urol 116: 169–171
Borzyskowski M, Mundy AR, Neville BGR, Park L, Kinder CH, Joyce MRL, Chantler C, Haycock HGB (1982) Neuropathic vesico-urethral dysfunction in children. Br J Urol 54: 641–644
Plunkett JM, Braren V (1979) Clean intermittent catheterisation in children. J Urol 121: 469–471
Brock WA, So EP, Harbach L, Kaplan GW (1981) Intermittent catheterization in the management of neurogenic vesico-urethral dysfunction in children. J Urol 125: 391–393
Kass EJ, McHugh T, Diokno AC (1979) Intermittent catheterization in children less than 6 years old. J Urol 121: 792–793
Diokno AC, Sonda LP, Hollander JB, Lapides J (1983) Fate of patients started on clean intermittent self catheterization therapy 10 years ago. J Urol 129: 1120–1122
Lyon RP, Scott MP, Marshall S (1975) Intermittent catheterization rather than urinary diversion in children with myelomeningocoele. J Urol 113: 409–417
Crooks KK, Enrile BG (1983) Comparison of the ileal conduit and clean intermittent catheterization for myelomeningocoele. Paediatrics 72: 203–206
Robinson RO, Cockram M, Strode M (1985) Severe handicap in spina bifida: no bar to intermittent self catheterization. Arch Dis Child 60: 760–762
Thompson IM, Lavetz R (1976) Oxybutynin in bladder spasm, neurogenic bladder and enuresis. Urology 8: 452–454
Mulcahy JJ, James HE, McRoberts WJ (1977) Oxybutynin chloride combined with intermittent clean catheterization in the treatment of myelomeningocoele patients. J Urol 118: 95–96
Hehir M, Fitzpatrick JM (1985) Oxybutynin and the prevention of urinary incontinence in spina bifida. Eur Urol 11: 254–256
EK A, Anderson KE, Ulmsten U (1978) The effects of norephedine and bethanecol on the human urethral pressure profile. Scand J Urol Nephrol 12: 97–104
Finkbeiner AE (1985) Is bethanecol chloride clinically effective in promoting bladder emptying. A literature review. J Urol 134: 443–449
Mundy AR (1986) Neuropathic bladder. In: Postlethwaite RJ (ed) Clinical paediatric nephrology. Wright, Bristol
Stephenson TP, Mundy AR (1985) Treatment of neuropathic bladder by enterocystoplasty and selective sphincterotomy or sphincter ablation and replacement. Br J Urol 57: 27–31
Mundy AR (1986) Artificial urinary sphincters. Arch Dis Child 61: 1–3
Nurse DE, Mundy AR (1987) 100 artificial sphincters. Br J Urol (in press)
Mundy AR (1987) Cystoplasty. In: Mundy AR (ed) Current operative surgery: urology. Bailliere Tindall, Eastbourne
Mundy AR, Stephenson TP (1985) Clam ileocystoplasty for the treatment of refractory urge incontinence. Br J Urol 57: 641–646
Mundy AR (1986) The surgical approach to the treatment of incontinence due to drug resistant detrusor instability with particular reference to clam ileocystoplasty. World J Urol 4: 45–51
Nurse DE, McCrae P, Stephenson TP, Mundy AR (1987) Substitution cystoplasty and its problems. Br J Urol (in press)
Kock NG, Nilssan AE, Nilssan LO, Norlen LJ, Philipsan BM (1982) Urinary diversion via a continent ileal reservoir: clinical results in 12 patients. J Urol 128: 469
Thuroff JN, Aitken P, Redmuller H, Engelmann U, Jacobi GH, Hohenfellner R (1986) The Mainz pouch (mixed augmentation ileum and cecum) for bladder augmentation and continent diversion. J Urol 136: 17–26
Duckett JW, Snyder HM (1986) Continent urinary diversion: variations on the Mitrofanoff principle. J Urol 136: 58–62
Mundy AR (1986) Complex urinary undiversion. Br J Urol 58: 640–643
Mundy AR (1987) Refunctional surgery of the lower urinary tract with particular reference to undiversion and the artificial sphincter. In: Hendry WF (ed) Recent advances in urology/andrology. Churchill Livingstone, Edinburgh
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Borzyskowski, M., Mundy, A.R. The management of the neuropathic bladder in childhood. Pediatr Nephrol 2, 56–66 (1988). https://doi.org/10.1007/BF00870381
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00870381