[Urologic monitoring of children with meningomyelocele].

In addition to neuropediatrical, neurosurgical and orthopedical care a continuous urological surveillance is indicated in children with myelodysplasia. Urodynamic assessment, voiding cystourethrography, kidney- and residual urine, ultrasound, excretory urography and radioisotope studies at birth and periodically until puberty are performed to evaluate the urinary tract. Early and specific treatment of bladder dysfunction is necessary to prevent urinary infection and preserve renal parenchyma. Urodynamic testing showed evidence of neurogenic bladder dysfunction in 13 of 14 evaluated children (including 8 newborns): detrusor-sphinkter-dyssynergia in 57 percent, detrusor hyperreflexia in 21 percent and detrusor areflexia in 14 percent. 4 of 5 children with detrusor-sphkincter-dyssynergia were treated effectively with anticholinergic agents and clean intermittend catheterization.