[Neurogenic bladder therapy in patients with spinal dysraphism. Actual strategy]

Retrospective evaluation of conservative and surgical treatment of detrusor hyperactivity in patients with spinal dysraphisms having been observed in our clinic during the last 20 years.

In the period 1989/2009, 87 patients in the age between 0 and 35 years suffering from the above disease were monitored. The period was divided into three terms. Term I: 1989/1995, Term II: 1996/2005, Term III: 2006/2009. 28 patients were followed-up in the Term I, 58 patients in the Term II and 69 patients in the Term III. The applied types of therapy (conservative, surgical, mini-invasive methods) were specified within the mentioned patients' groups and substitution alterations were monitored.

54 patients were treated conservatively, 33 patients underwent an operation. During the Term I, 23 of the total 28 patients were treated conservatively, 5 (17.9%) patients were operated (3x ileocecal replacement, 2x ileocystoplasty). In Term II, 58 patients were treated, 23 (39.7%) thereof were operated (18x ileocystoplasty, 4x gastrocystoplasty, 1x sigmoideocystoplasty). In the Term III, 69 patients were followed-up and treated, 5 (7.2%) of them were operated (3x ileocystoplasty, 1x gastrocystoplasty, 1x sigmoideocystoplasty), and other 5 (7.2%) underwent a mini-invasive procedure by Botulinumtoxin A application.