Management of vesico-ureteric reflux in myelodysplasia neurogenic bladder

During the period 1978-87, 22 patients with myelodysplasia had surgery for vesico-ureteric reflux (VUR) and seven patients with VUR were managed non-operatively. Clean intermittent catheterization was an integral part of the management in both the operated and non-operated cases. The majority of patients had reflux-related upper tract changes pre-operatively, but after operation the urinary tract was stabilized in all but one kidney which was lost. Transverse advancement ureteric reimplantation or the pull-through technique provided satisfactory results, giving a total of 29 refluxing units managed surgically.