Fate of vesicoureteral reflux in children with neuropathic bladders managed by intermittent catheterization.

During the last 9 years 49 children with vesicoureteral reflux and neurogenic bladder dysfunction were treated with intermittent catheterization. Reflux spontaneously abated in 22 of 72 ureters (31 per cent). Reflux has been followed non-operatively in 17 ureters without renal deterioration. Reimplantation was successful in 24 ureters. In no instance was there ureterovesical obstruction or recurrence of the reflux and in none of the 12 unilateral reimplantations did contralateral reflux develop. Our experience suggests that children with reflux may be managed safely by intermittent catheterization, and that ureteroneocystostomy is reliable and effective in neurogenic bladder disease provided that bladder dysfunction is controlled.