[Bladder disorders in young adults with myelomeningocele: results of urodynamic-electromyographic studies]

Voiding disorders are common in patients with myelomeningocele (MMC) and are of great prognostic importance. We performed urodynamic-electromyographic measurements in 11 adolescent MMC patients who had undergone immediate postnatal surgery. None of our patients was able to urinate normally, and 9 suffered from some form of incontinence. The detrusor vesicae was hyper-reflexive in 6 patients and hypo-reflexive in 4. The bladder neck was never obstructive, but the striated sphincter was obstructive in 4. In 2 of these detrusor sphincter dyssynergy was found, and in 2 patients a non-relaxing sphincter was present. There was no correlation between the localization of the MMC and the type of dysfunction. The aim of any treatment of these disorders should be to prevent the development of vesico-ureteral reflux. Appropriate treatment requires the type of bladder dysfunction to be precisely known. Hence a urodynamic-electromyographic assessment should be performed in all MMC patients with voiding problems.