With early closure and effective treatment of common complications such as hydrocephalus and neuropathic bladder
, the majority of these patients survive into adulthood--a marked contrast to the situation 50 years ago when survival was around 10%.
The intent of this review is to outline the investigation and treatment options for patients with a neuropathic bladder
, with an emphasis on treatment goals as they progress through their lifetime.
Jackson et al., "Progression of renal insufficiency in children and adolescents with neuropathic bladder
is not accelerated by lower urinary tract reconstruction," Journal of Urology, vol.
3 demonstrates the cystometrogram of a patient with a neuropathic bladder
secondary to MMC.
Indication: Bladder outlet obstruction and dysfunction caused by a neuropathic bladder
, a nonneurogenic neurogenic bladder, posterior urethral valves and the exstrophy-0epispadias complex can often lead to urinary incontinence and renal dysfunction in children.
At the other end of the neuropathic bladder
spectrum is the atonic bladder with an underactive detrusor that shows increased capacity and compliance on UDS.
Moosavi, P Tajik et al., "Intravesical injection of botulinum toxin type A: management of neuropathic bladder
and bowel dysfunction in children with myelomeningocele," Urology, vol.
Urinary tract infection associated with conditions causing urinary tract obstruction and stasis, excluding urolithiasis and neuropathic bladder
. World J Urol 2012; 30:77-83.
Contemporary role of suprapubic cystostomy in treatment of neuropathic bladder
dysfunction in spinal cord injured patients.
Children with neuropathic bladder
due to myelomeningocele or other spinal cord lesions commonly have accompanying neuropathic bowel dysfunction (NBD).[sup.1,2] Neuropathic bowel dysfunction can manifest as chronic constipation, fecal incontinence or both.[sup.3]-[sup.5] Neuropathic bowel dysfunction has a significant negative impact on a patient's quality of life and functional capacity.[sup.6]
Transitional cell carcinoma following augmentation cystoplasty for the neuropathic bladder
. J Urol 2004;172:1649-51http://dx.doi.org/10.1097/01.ju.0000140194.87974.56.
Screening cystoscopy and biopsy in patients with neuropathic bladder
and chronic suprapubic indwelling catheters: is it valid?