[Cystometric investigations of neurogenic bladder-dysfunction in children (author's transl)]

Clinical and cystometrical studies were performed in 48 patients with myelomeningocele. From the clinical point of view four of the patients were completely continent. Fiften patients showed a so called "social continence" with periods of continence lasting for more than two hours (40%). Cystomanometric evaluations, however, revealed that there was a complete continence only in one of the 48 patients. Twenty-one patients showed a spastic or reflex bladder (44%), twentysix (54%) an adynamic bladder. The so called "social continence" could be observed as well in spastic-as in adynamic bladders. The most important parameters to realize neurogenic disturbances of micturition is the dyssynergia of the contraction of the detrusor muscle and the relaxation of the external vesical sphincter. Considering this, Stark's classification of adynamic and spastic bladders according to amplitude of the contractions of the detrusor muscle is helpful only in combination with the cystometrical and myographical datas of the bladder outlet.