Management of urinary incontinence in children with myelomeningocele

Several forms of treatment of lower urinary tract functional disorders have been attempted in children with myelomeningocele (MMC). Intravesical electrical stimulation was attempted in 10 patients. Urinary control was achieved in one and in the remaining 9 either the bladder was resistant to stimulation or the children discontinued the treatment due to loss of interest. A combined anticholinergic and calcium blocking agent, terodiline, was tested in 8: symptoms improved in 4, but bladder compliance was unchanged. Clean intermittent catheterization, either alone or in combination with medication, seems to be the most beneficial treatment.