[Urodynamic diagnosis and treatment of neurogenic bladder dysfunction]

A group of 55 patients (28M, 27F) with neurogenic bladder dysfunction was studied. Patient age ranged from 1m. to 20 years (mean age 9.1 years). Most of the patients had neurogenic bladder secondary myelomeningocele (70%). The urodynamic investigations demonstrated detrusor hyperreflexia in 50 (poor compliance in 28p) detrusor areflexia in 3 and normal bladder in 2. Six patients hadn't incontinence and didn't need treatment. The rest (49p), couldn't be dry more than 2 hours. After treatment (anticholinergic, alpha adrenergic agonist, alpha-beta adrenergic agonist, I. C. and bladder augmentation), the continence was improved satisfactorily in 38 patients (77.5%). In conclusion, we think that early treatment from neonatal period, supported with urodynamic studies may prevent long-term renal damage and most patients with neurogenic bladder do not require surgical intervention to improve continence because it can be controlled satisfactorily by other means.