Combined surgery and intermittent catheterization for neurogenic bladder dysfunction in children.

Intermittent catheterization is a valid treatment modality in the management of the neuropathic bladder. Numerous adjunctive surgical procedures have been tried to improve continence and to improve or preserve renal function. These procedures, performed on 38 of 82 patients on long-term intermittent catheterization, are preferable to urinary diversion and possibly to the implantation of prosthetic or artificial urinary sphincters. Uretero-ileocecocysto-urethroplasties have not been successful in our hands, but the other procedures certainly offer a preferable alternative to the treatment modalities in use up to only 4 years before this bicentennial year!