[Results of intermittent catheterization in neurogenic bladder in children and adolescents. 165 cases from 1976 to 1986].

Intermittent clean catheterization (CIC) has been proposed in 1975 for treatment of neurogenic bladder in children and tean-agers. We report herein the results of our experience from 1976 to 1986 with this method in a large number of patients with bladder dysfunction. 165 patients were included in this study (111 girls and 54 boys). 9 patients were lost for follow-up. Myelomeningocele was the cause of the neurogenic bladder in 132 cases. The effects on continence, upper tracts, and urinary tract infection are studied. Incontinence was managed by CIC in all 156 patients, with CIC alone (40 patients) or in association with oxybutynin (21 patients), enterocystoplasty, (20 patients), one method of increasing peripheral resistances (i.e. urethral lengthening, (8 patients), abdominal transposition of the urethra) (2 patients]. 40 very young children remain incontinent, 84 became continent; there were four technical failures, and an other method was used in 28 patients. Status of the upper urinary tracts was determined by IVP and cystography in 156 patients. IVP was normal in 123 cases (there was no change in 95%), and abnormal in 33 cases (there was improvement in 28 cases or no change in 3 cases). These data confirm those found in our previous study: this technique appears simple, harmless and effective for protection of the upper urinary tract and for control of urinary incontinence.