[Urologic aspects of myelodysplasias in children].

At least 25% of the clinical problems seen in pediatric urology are the result of neurologic lesions that affect lower urinary tract function. The advent of clean intermittent catheterization and refinements in techniques of urodynamic studies in children dramatically changed the way this pediatric population was traditionally managed. Along with this change came a greater understanding of the pathophysiology of the many diseases that primarily affect children. The applicability of urodynamic testing has expanded to the point where most pediatric urologic centers now believe that functional assessment of the lower urinary tract is an essential element in the evaluation process and is as important as x-ray visualization in characterising and managing these abnormal conditions. The natural outcome of early functional investigation has been the advocacy of proactive or early aggressive management of children who are now considered at risk of urinary tract deterioration based on specific hostile urodynamic parameters. This paper first defines the testing process as it applies to children and second, conservative and surgery methods to prevent upper urinary tract deterioration and to correct continence.