International Urology and Nephrology

, Volume 7, Issue 1, pp 13–22 | Cite as

Development of the upper urinary tract in myelomeningocele and consequent urological care

  • H. Madersbacher


The findings in the upper urinary tract of 58 patients with MMC and neurogenic bladder dysfunction are discussed and therapeutical consequences are considered. In a group of 28 neonates, investigated within the first three months of life, only 10% showed some abnormalities of the upper urinary tract and (or) reflux, in a second group of 21 children, over the age of 2 years when first seen, the occurrence rate of dilatation of the upper urinary tract and of pyelonephritis signs was already doubled, whereas adults with operated MMC showed in 75% severe pathological changes.

The situation of neonates born with MMC may be in some aspects compared to patients suffering from acute traumatic cord lesion with neurogenic bladder dysfunction. It was already shown that, in spite of neurogenic bladder dysfunction, it is possible in paraplegics by appropriate and mainly conservative treatment to prevent progressive destruction of the upper urinary tract, once considered to be unavoidable.

The key to better results in the children with MMC should therefore be early and prompt care and close follow-up. The importance of regular bladder emptying, low dosage, long-term antibiotic treatment and measures like forced urethral dilatation and sphincterotomy is stressed. Our results so far in neonatal urological care of children with MMC are encouraging.


Public Health Urinary Tract Therapeutical Consequence Conservative Treatment Antibiotic Treatment 
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  1. 1.
    Bors, E., Comarr, A. E.: in Neurological Urology, Chapter X, p. 357, S. Karger-, Basel-München-Paris-New York 1971.Google Scholar
  2. 2.
    Carlson, H. E.: Urologic problems in meningomyelocele.J. Urol., 95, 245 (1964).Google Scholar
  3. 3.
    Eckstein, H. B., Cooper, D. G. W., Howard, E. R., Pike, J.: Cause of death in children with meningomyelocele or hydrocephalus.Arch. Dis. Childh. 42, 163 (1967).Google Scholar
  4. 4.
    Eckstein, H. B.: Urinary control in children with myelomeningocele.Brit. J. Urol., 40, 191 (1969).Google Scholar
  5. 5.
    Ericsson, N. O.: Myelomeningocele: Urologic Aspects, p. 19, Göteborg 1967, Elandus Boktrycheri Akhebary.Google Scholar
  6. 6.
    Guttmann, L.: Statistical survey on one thousand paraplegics and initial treatment of traumatic paraplegia.Proc. roy. Soc. Med. 47, 1099 (1954).Google Scholar
  7. 7.
    Guttmann, L.: Personal communication (1974).Google Scholar
  8. 8.
    Johnston, J. H., Kathel, B. L.: The obstructed neurogenic bladder in the newborn.Brit. J. Urol. 43, 206 (1971).Google Scholar
  9. 9.
    Kuffer, F.: Die Myelomeningocele. Die Evolution der oberen Harnwege und die Bedeutung der Elektro-Zystotonometrie. Verlag Hans Huber, Bern-Stuttgart-Wien, 1972.Google Scholar
  10. 10.
    Madersbacher, H.: Die Betreuung von Kleinkindern mit MMC. Congressus paediatricochirurgicus, Prague, 22–24, 5, 1974,Abstracts, p. 71.Google Scholar
  11. 11.
    Shochat, S. J., Perlmutter, A. D.: Myelodysplasia with severe hydronephrosis: the value of urethral dilatations.J. Urol., 157, 146 (1972).Google Scholar
  12. 12.
    Straffon, R. A., Kyle, K., Corvalan, J.: Techniques of cutaneous ureterostomy and results in 51 patients.J. Urol., 103, 138 (1970).Google Scholar

Copyright information

© Akadémiai Kiadó 1975

Authors and Affiliations

  • H. Madersbacher
    • 1
  1. 1.Department of UrologyUniversity HospitalInnsbruckAustria

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