[Lower urinary tract function in myelomeningocele. Long-term follow-up data]

We have analyzed long-term follow-up data of the lower urinary tract in 58 myelodysplastic patients. The patients consisted of 16 males and 42 females, whose age varied from 3 months to 16 years old (mean of 7). The follow-up periods ranged from 18 to 100 months (mean of 82). 1. While the bladder compliance of 41 patients conservatively treated with clean intermittent catheterization increased significantly from 5.1 to 11.1 ml/cmH2O, that of 17 patients who underwent anti-reflux surgery failed to do so. 2. A significant correlation was observed between bladder deformity and bladder compliance. A severe deformity was encountered more in the patients surgically treated. 3. Uninhibited contractions decreased in magnitude or disappeared in 26 patients, and increased in strength or developed newly in 8. The remaining 24 cases did not demonstrate them at all. 4. The maximum urethral closure pressure changed +/- 20 percent of the initial value in 27 of 38 patients (71%). The mean value tended to fall at 60 cmH2O.