Neurogenic Vesical Dysfunction

  • Richard C. Rink
  • Anthony J. Casale
Part of the Atlas of Clinical Urology book series (ACU)


Many tremendous advances in the management of neurovesical dysfunction have taken place over the past two decades. Gone are the days of severe hydronephrosis, renal failure, and even death from neurogenic urinary dysfunction. Only rarely do we now see children who present with significant urinary tract changes. The social debilitation from life-long incontinence or incontinent abdominal wall urinary stomas should also only be a memory. Combining these advances with newer surgical approaches to fecal incontinence should now allow these children to be free of diapers. The advances made in medical and surgical approaches to neurogenic bladders have greatly changed overall pediatric urologie care, allowing reconstruction of even the most significant anatomic congenital anomalies.


Bladder Capacity Neurogenic Bladder Leak Point Pressure Intravesical Pressure Bladder Augmentation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Bauer SB, Hallett M, Khoshbin S, et al.: Predictive value of urodynamic evaluation in newborns with myelodysplasia. JAMA 1984, 252:650–652.PubMedCrossRefGoogle Scholar
  2. 2.
    Van Gool JD: Vesicoureteral reflux the urodynamic dimension. Dial Pediatr Urol 1983, 6:12.Google Scholar
  3. 3.
    McLorie GA, Perez-Marero R, Csima A, Churchill BM: Determinants of hydronephrosis and renal injury in patients with myelomeningocele. J Urol 1988, 140:1289–1292.PubMedGoogle Scholar
  4. 4.
    Bauer SB, Labib KB, Dieppa RA, Retik AB: Urodynamic evaluation in a boy with myelodysplasia and incontinence. Urology 1977, 10:354–362.PubMedCrossRefGoogle Scholar
  5. 5.
    Stark GD: Spina Bifida: Problems and Management. Oxford: Blackwell Scientific Publications; 1977.Google Scholar
  6. 6.
    Lais A, Kasabian NG, Dyro FM, et al.: The neurosurgical implications of continuous neurourological surveillance of children with myelodysplasia. J Urol 1993, 150:1879–1883.PubMedGoogle Scholar
  7. 7.
    Anderson FM: Occult spinal dysraphism: a series of 73 cases. Pediatrics 1975, 55:826–835.PubMedGoogle Scholar
  8. 8.
    Mandell J, Bauer SB, Hallett M, et al.: Occult spinal dysraphism: a rare but detectable cause of voiding dysfunction. Urol Clin North Am 1980, 7:349–356.PubMedGoogle Scholar
  9. 9.
    Keating MA, Rink RC, Bauer SB, et al.: Neurourological implications of the changing approach in management of occult spinal lesions. J Urol 1988, 140:1299–1301.PubMedGoogle Scholar
  10. 10.
    Satar N, Bauer SB, Shefner J, et al.: The effects of delayed diagnosis and treatment in patients with occult spinal dysraphism. J Urol 1995, 154:754–758.PubMedCrossRefGoogle Scholar
  11. 11.
    Guzmann L, Bauer SB, Hallett M, et al.: Evaluation and management of children with sacral agenesis. Urology 1983, 22:506–510.CrossRefGoogle Scholar
  12. 12.
    Joseph DB:The effect of medium-fill and slow-fill cystometry on detrusor pressure in infants and children with myelodyplasia. J Urol 1992, 147:444–446.PubMedGoogle Scholar
  13. 13.
    Bauer SB: An approach to neurogenic bladder: an overview. Probl Urol 1994, 8:441.Google Scholar
  14. 14.
    Berger RM, Maizels M, Moran GL, et al.: Bladder capacity (ounces) equals age (years) plus 2 predicts normal bladder capacity, aids in diagnosis of abnormal voiding patterns. J Urol 1983, 129:327.Google Scholar
  15. 15.
    Houle AM, Gilmour RF, Churchill BM, et al.: What volume can a child normally store in the bladder at a safe pressure? J Urol 1993, 149:561–564.PubMedGoogle Scholar
  16. 16.
    Palmer LS, Richards I, Kaplan WE: Age related bladder capacity and bladder capacity growth in children with myelomeningocele. J Urol 1997, 158:1261–1264.PubMedCrossRefGoogle Scholar
  17. 17.
    McGuire EJ, Woodside JR, Borden TA, Weiss RM: Prognostic value of urodynamic testing in myelodysplastic patients J Urol 1981, 126:205–209.PubMedGoogle Scholar
  18. 18.
    Maizels M, Firlit CF: Pediatric urodynamics: clinical comparison of surface vs. needle pelvic floor/external sphincter electromyography. J Urol 1979, 122:518–522.PubMedGoogle Scholar
  19. 19.
    Rink RC, McLaughlin KP: Indications for enterocystoplasty and choice of bowel segment. Probl Urol 1997, 8:389.Google Scholar
  20. 20.
    Bauer SB: neurogenic dysfunction of the lower urinary tract in children. In Campbell’s Urology. Edited by Walsh PC, Retik AB, Vaughn ED, Wein AJ. Philadelphia: WB Saunders; 1998:2019–2053.Google Scholar
  21. 21.
    Lapides J, Diokno AC, Silber SJ, Lowe BS: Clean, intermittent self-catheterization in the treatment of urinary tract disease. J Urol 1972, 107:458–461.PubMedGoogle Scholar
  22. 22.
    Kasabian NG, Vlachiotis JD, Lais A, et al.:The use of intravesical oxybutinin chloride in patients with destrusor hypertonicity and detrusor hyperreflexia. J Urol 1994, 151:94–945.Google Scholar
  23. 23.
    Rink RC, Mitchell ME: Role of enterocystoplasty in reconstructing the neurogenic bladder. In Common Problems in Pediatric Urology. Edited by Gonzalez ET Jr, Roth D. St. Louis: Mosby Yearbook; 1991:192.Google Scholar
  24. 24.
    Bloom DA, Knechtel JM, McGuire EJ: Urethral dilation improves bladder compliance in children with myelomeningocele and high leak point pressures. J Urol 1990, 144:430–433.PubMedGoogle Scholar
  25. 25.
    Duckett JW Jr: Cutaneous vesicostomy in childhood. Urol Clin North Am 1974, 1:485–495.PubMedGoogle Scholar
  26. 26.
    Kaplan WE, Richards TW, Richards I: Intravesical transurethral bladder stimulation to increase bladder capacity. J Urol 1989, 142:600–602.PubMedGoogle Scholar
  27. 27.
    Cheng EY, Richards I, Balcom A, et al.: Bladder stimulation therapy improves bladder compliance: results from a multi-institutional trial. J Urol 1996, 165:761.Google Scholar
  28. 28.
    Cheng EY, Richards I, Kaplan WE: Use of bladder stimulation in high risk patients. J Urol 1996, 156:749–752.PubMedCrossRefGoogle Scholar
  29. 29.
    Decter RM, Snyder P, Laudermilch C: Transurethral electrical bladder stimulation: a followup report. J Urol 1994, 152:812–814.PubMedGoogle Scholar
  30. 30.
    Light JK, PietroT: Alteration in detrusor behavior and the effect on renal function following the insertion of the artificial urinary sphincter. J Urol 1986, 136:632–635.PubMedGoogle Scholar
  31. 31.
    Bauer SB, Reda EF, Colodny AH, Retik AB: Detrusor instability: a delayed complication in association with the artificial sphincter. J Urol 1986, 135:1212–1215.PubMedGoogle Scholar
  32. 32.
    Kronner KM, Simmons G, Kropp BP, et al.: Artificial urinary sphincter in the treatment of urinary incontinence.: preoperative urodynamics do not predict the need for future bladder augmentation [part 2]. Pediatrics 1997, 100:559.Google Scholar
  33. 33.
    Goldwasser B, Webster GD: Augmentation and substitution enterocystoplasty. J Urol 1986, 135:215–224.PubMedGoogle Scholar
  34. 34.
    Rink RC, Hollensbe D, Adams MC: Complications of bladder augmentation in children and comparison of gastrointestinal segments. AUA Update Series 1995, Lesson 15, 14:122.Google Scholar
  35. 35.
    Hinman F Jr: Selection of intestinal segments for bladder substitution: physical and physiological characteristics: J Urol 1988, 139:519–523.PubMedGoogle Scholar
  36. 36.
    Koff SA: Guidelines to determine the size and shape of intestinal segments used for reconstruction. J Urol 1988, 140:1150–1151.PubMedGoogle Scholar
  37. 37.
    Mitchell ME, Rink RC: Urinary diversion and undiversion. Urol Clin North Am 1985,12:111–122.PubMedGoogle Scholar
  38. 38.
    Rink RC: Choice of materials for bladder augmentation. Curr Opin Urol 1995, 5:300.CrossRefGoogle Scholar
  39. 39.
    King LR: Cystoplasty in children. In Bladder Reconstruction and Continent Urinary Diversion. Edited by King LR, Stone AR, Webster GD. St. Louis: Mosby Yearbook; 1991: 115–125.Google Scholar
  40. 40.
    Gonzalez R, Cabral BHP: Rectal continence after enterocystoplasty. Dialog Pediatr Urol 1987, 10:3–4.Google Scholar
  41. 41.
    Mitchell ME, Piser JA: Intestinocystoplasty and total bladder replacement in children and young adults: follow up in 129 cases. J Urol 1987, 138:579–584.PubMedGoogle Scholar
  42. 42.
    Hall MC, Koch MO, McDougall WS: Metabolic consequences of urinary diversion through intestinal segments. Urol Clin North Am 1991, 18:725–735.PubMedGoogle Scholar
  43. 43.
    Sinaiko ES: Artificial bladder from segment of stomach any study of the effect of urine on gastric secretion. Surg Gynecol Obstet 1956, 102:433.PubMedGoogle Scholar
  44. 44.
    Leong CH, Ong GB: Gastrocystoplasty in dogs. Surgery 1977, 82:1.Google Scholar
  45. 45.
    Kulb TB, Rink RC, Mitchell ME: Gastrocystoplasty in azotemic canines. Presented at the American Urological Association, North Central Section Meeting. Palm Springs, CA; 1986.Google Scholar
  46. 46.
    Piser JA, Mitchell ME, Kulb TB, et al.: Gastrocystoplasty in colocystoplasty in canines: the metabolic consequences of acute saline and acid loading. J Urol 1987, 138:1009–1013.PubMedGoogle Scholar
  47. 47.
    Kennedy HA, Adams MC, Mitchell ME, et al.: Chronic renal failure in bladder augmentation: stomach versus sigmoid in the canine model. J Urol 1988, 140:1138–1140.PubMedGoogle Scholar
  48. 48.
    Adams MA, Mitchell ME, Rink RC: Gastrocystoplasty: an alternative solution to the problem of urological reconstruction in the severely compromised patient. J Urol 1988, 140:1152–1156.PubMedGoogle Scholar
  49. 49.
    Adams MC, Bihrle R, Rink RC: The use of stomach. In Urologie Reconstruction 1995, AUA Update, 14:218.Google Scholar
  50. 50.
    Atala A, Bauer SB, Hendren WH, et al.: The effect of gastric augmentation on bladder function. J Urol 1993, 149:1099–1102.PubMedGoogle Scholar
  51. 51.
    Gosalbez R Jr, Woodard JR, Boecker, BH, et al.: Urodynamics of gastrocystoplasty and continent gastric reservoirs: a critical review. Presented at the American Academy of Pediatrics, Urology Section Meeting. San Francisco: 1992.Google Scholar
  52. 52.
    Kronner KM, Casale AJ, MP, et al.: Bladder calculi in the augmented bladder: strategies for treatment and preventive measures to keep the incidence low. Pediatrics.Google Scholar
  53. 53.
    Kaefer M, Hendren WH, Bauer SB: Reservoir calculi: a comparison between reservoirs constructed from stomach and other enteric segments. Pediatrics.Google Scholar
  54. 54.
    Nguyen DH, Bain MA, Salmonson KL, et al.: The syndrome of dysuria and hematuria in pediatric urinary reconstruction with stomach. J Urol 1993, 150:707–709.PubMedGoogle Scholar
  55. 55.
    El-Ghoneimi A, Muller C, Guys JM, et al.: Functional outcome and specific complications of gastrocystoplasty in bladder exstrophy cripples. Pediatrics.Google Scholar
  56. 56.
    Hendren WH, Hendren RB: Bladder augmentation: experience with 129 children and young adults. J Urol 1990, 144:445–453.PubMedGoogle Scholar
  57. 57.
    Hirst G: Ileal and colonic cystoplasties. Edited by Rowland RG. Probl Urol 1991, 5:223.Google Scholar
  58. 58.
    Blyth B, Ewalt DH, Duckett JW, Snyder HM III: Lithogenic properties of enterocystoplasty. J Urol 1992, 148:575–577.PubMedGoogle Scholar
  59. 59.
    Palmer LS, Franco I, Kogan SJ, et al.: Urolithiasis in children following augmentation cystoplasty. J Urol 1993, 150:726–729.PubMedGoogle Scholar
  60. 60.
    Franco I, Levitt SB: Urolithiasis in the patient with augmentation cystoplasty: pathogenesis and management. AUA Update Series 1997, 17:10–15.Google Scholar
  61. 61.
    Gearhart JP: Mucus secretion in augmented bladder: Dialog Pediatr Urol 1987, 10:6.Google Scholar
  62. 62.
    Pope JC, Adams MC, Keating MA, et al.: Spontaneous perforation of the augmented bladder: from silence to chaos. Presented at American Urologic Association Meeting. New Orleans, LA; April 1997.Google Scholar
  63. 63.
    Sheiner JR, Kaplan GW: Spontaneous bladder rupture following enterocystoplasty. J Urol 1988, 140:1157–1158.PubMedGoogle Scholar
  64. 64.
    Glass RB, Rushton HG: Delayed spontaneous rupture of the augmented bladder in children and adolescence: importance of cystography. AJR Am J Roentgenol 1992, 158:833–835.PubMedCrossRefGoogle Scholar
  65. 65.
    Braverman RM, Lebowitz RL: Perforation of the augmented urinary bladder in nine children and adolescence: importance of cystography. AJR Am J Roentgenol 1991, 157:1059–1063.PubMedCrossRefGoogle Scholar
  66. 66.
    Glass RB, Rushton HG: Delayed spontaneous rupture of the augmented bladder in children: diagnosis with sonography and CT. AJR Am J Roentgenol 1992, 158:833–835.PubMedCrossRefGoogle Scholar
  67. 67.
    Cartwright PC, Snow BW: Bladder autoaugmentation: partial detrusor excision to the bladder without the use of bowel. J Urol 1989, 142:1050–1053.PubMedGoogle Scholar
  68. 68.
    Landa HM, Moorhead JD: Detrusorectomy. Probl Pediatr Urol 1994, 8:404.Google Scholar
  69. 69.
    Snow BW, Cartwright PC: Bladder autoaugmentation. Urol Clin North Am 1996, 23:323–331.PubMedCrossRefGoogle Scholar
  70. 70.
    Ehrlich RM, Gershman A: Laparoscopic seromyotomy (autoaugmentation) for non neurogenic neurogenic bladder in a child: initial case report. Urology 1993, 42:175–178.PubMedCrossRefGoogle Scholar
  71. 71.
    Buson H, Manivel JC, Dayanc M, et al.: Seromuscular colocystoplasty lined with urothelium: experimental study. Urology 1994, 44:743–748.PubMedCrossRefGoogle Scholar
  72. 72.
    Dewan PA, Byard R: Autoaugmentation gastrocystoplasty in a sheep model. Br J Urol 1993, 72:56–59.PubMedCrossRefGoogle Scholar
  73. 73.
    Gonzalez R, Buson H, Reid C: Seromuscular colocystoplasty lined with urothelium: experience with 16 patients. Urology 1994, 45:124.CrossRefGoogle Scholar
  74. 74.
    Vates TS, Smith C, Gonzalez R: Importance of early bladder distention for the success of the seromuscular colocystoplasty lined with urothelium (SCLU). Pediatrics.Google Scholar
  75. 75.
    Mitchell ME, Rink RC, Adams MC: Augmentation cystoplasty, implantation of artificial sphincter in men and women, and reconstruction at the dysfunctional urinary tract. In Campbell’s Urology, edn 6. Edited by Walsh PC, Retik AB, Stamey TA,Vaugh ED Jr. Philadelphia: WB Saunders; 1992:2630–2653.Google Scholar
  76. 76.
    Bellinger MF: Ureterocystoplasty: a unique method for vesical augmentation in children.; J Urol 1993, 149:811–813.PubMedGoogle Scholar
  77. 77.
    Dewan PA, Nicholls EA, Goh DW: Ureterocystoplasty: an extra peritoneal urothelial bladder augmentation technique. Eur Urol 1994, 26:85–89.PubMedGoogle Scholar
  78. 78.
    Reinberg Y, Allen RC, Vaugh M, et al.: Nephrectomy combined with lower abdominal extraperitoneal ureteral bladder augmentation in the treatment of children with vesicoureteral reflux dysplasia syndrome. J Urol 1995, 153:177–179.PubMedCrossRefGoogle Scholar
  79. 79.
    Adams MC, Brock JW, Pope JC, Rink RC: Ureterocystoplasty: is it necessary to detubularize the distal ureter? Presented at American Urologie Association. New Orleans, LA; April 1997.Google Scholar
  80. 80.
    Rink RC, Adams MC: Augmentation cystoplasty. In Campbell’s Urology. Edited by Walsh PC, Retik AB, Vaughn ED Jr, Wein A. Philadelphia: WB Saunders; 1997:3167–3189.Google Scholar
  81. 81.
    Landau EH, Jayanthi VR, Khoury AE, et al.: Bladder augmentation: ureterocystoplasty vs ileocystoplasty. J Urol 1994, 152:716–719.PubMedGoogle Scholar
  82. 82.
    Rink RC, Adams MC: Augmentation cystoplasty. In Textbook of Operative Urology. Philadelphia: WB Saunders; 1996.Google Scholar

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© Springer Science+Business Media New York 2003

Authors and Affiliations

  • Richard C. Rink
  • Anthony J. Casale

There are no affiliations available

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