Vesico-ureteric reflux in the neuropathic bladder with particular reference to the development of renal scarring

96 unselected and consecutive patients with myeloceles (n = 75), meningomyeloceles (n = 17) and lipomatous meningomyeloceles (n = 4) were admitted to the Wessex Regional Paediatric Surgical Centre between 1st July, 1969, and 31st December, 1971, for early closure of the spinal defect. Intravenous pyelography and cystography were performed in the first month following closure of the back and repeated at 1, 3 and 5 years of age and at 4 months in patients with upper tract dilatation or vesico-ureteric reflux at the initial examination. The mortality was 30.2% in the first year of life. Primary associated renal anomalies were found in 10.4%. Vesico-ureteric reflux was present in 18 patients by 1 month of age (28%) and in 29 patients by 5 years of age (45%). New renal cortical scars developed in 9 patients. Urinary infection, intrarenal reflux and a bladder with a high urethral resistance were factors of aetiological significance.