[Management of vesicoureteral reflux in children with neurogenic bladder--retrospective studies of antireflux surgery].

During the last 3.5 years, 18 children and 9 adults with vesicoureteral reflux and neurogenic bladder dysfunction were seen at our hospital, and 11 children and 4 adults required antireflux surgery. The criteria of repair were progressive renal deterioration and/or uncontrollable urinary infection. Surgery was applied mainly to the conditions of detrusor hyperreflexia and/or lower urinary tract obstruction. The combined technique of Politano-Leadbetter and Glenn-Anderson was used in 8 children and 3 adults, and the Cohen technique was used in 3 children and 1 adult. Surgery was successful that is, cessation of reflux and no obstruction, was achieved in all but one patient, who had received radical hysterectomy previously. Though recurrent episodes of lower urinary tract infection persisted in some cases after operation, over-all usage of antibiotics was reduced. Seven children with reflux and uninhibited bladder, though some of them with high grade reflux, were managed successfully by anticholinergic drug or transcutaneous electrical stimulation.