Evaluation and Long-term Management of Neurogenic Bladder in Spinal Dysraphism

Neoreviews. 2019 Dec;20(12):e711-e724. doi: 10.1542/neo.20-12-e711.

Abstract

Spinal dysraphism, which includes conditions such as myelomeningocele and sacral agenesis, is one of the most common causes of congenital lower urinary tract dysfunction. Early evaluation of the neurogenic bladder serves to minimize renal damage, and the main goals of management include preserving renal function, achieving acceptable continence, and optimizing quality of life. The survival of patients with such conditions has improved to greater than 80% reaching adulthood, owing to advances in diagnostic and therapeutic modalities. The result is a real, and unfortunately often unmet, need for successful transitional care in this complex patient population. Clinicians must be able to identify the unique challenges encountered by patients with neurogenic bladder as they shift through different stages of their life.

Publication types

  • Review

MeSH terms

  • Abnormalities, Multiple / diagnostic imaging
  • Acetylcholine Release Inhibitors / therapeutic use*
  • Botulinum Toxins, Type A / therapeutic use*
  • Cholinergic Antagonists / therapeutic use*
  • Fetal Therapies
  • Humans
  • Hydronephrosis / etiology
  • Hydronephrosis / prevention & control
  • Meningocele / complications
  • Meningocele / diagnostic imaging
  • Meningomyelocele / complications
  • Meningomyelocele / diagnostic imaging
  • Meningomyelocele / surgery
  • Sacrococcygeal Region / abnormalities
  • Sacrococcygeal Region / diagnostic imaging
  • Spina Bifida Occulta / complications
  • Spina Bifida Occulta / diagnostic imaging
  • Spinal Dysraphism / complications
  • Spinal Dysraphism / diagnostic imaging
  • Spinal Dysraphism / surgery
  • Transition to Adult Care
  • Ultrasonography, Prenatal
  • Urinary Bladder
  • Urinary Bladder, Neurogenic / diagnosis
  • Urinary Bladder, Neurogenic / physiopathology
  • Urinary Bladder, Neurogenic / therapy*
  • Urinary Catheterization / methods*
  • Urinary Tract Infections
  • Urodynamics
  • Urology
  • Vesico-Ureteral Reflux
  • Watchful Waiting

Substances

  • Acetylcholine Release Inhibitors
  • Cholinergic Antagonists
  • Botulinum Toxins, Type A

Supplementary concepts

  • Sacral defect and anterior sacral meningocele