Early evaluation and treatment of children with meningomyelocele

William E Kaplan

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

There have been significant advances in the care of children born with myelodysplasia. Early recognition of the pathophysiology of the defect can aid in prompt and appropriate therapy. The overall concept of maintaining a compliant bladder that will either effectively empty or be emptied by clean intermittent catheterization is critical. Preservation of normal renal function is dependent on strict and continuous vigilance. Aggressive management of reflux and alterations in bladder compliance is essential. New techniques for bladder management as well as creative augmentation surgical procedures bode well for the future management of these children. There have been significant advances in the diagnosis and management of children born with myelodysplasia. A slow but progressive understanding of the effects of bladder compliance on the entire urinary tract has stimulated new methods of both medical and surgical treatment of these children. In addition to advanced, creative surgical techniques, an increased knowledge of pharmacotherapy, biofeedback, and stimulation processes that may obviate significant surgical procedures have surfaced. Advances in radiologic procedures, specifically computed tomography and magnetic resonance imaging in conjunction with aggressive urodynamic evaluations, have helped to diagnose long-term neurologic complications such as tethered spinal cord. In all, a variety of new procedures have added greatly to the medical and surgical armamentarium with which to treat these children. The overall lifespan has been advanced, with significant improvement in quality of life. This in itself now provides challenges for the future because as young children become adolescents and adults, chronic problems must be managed as aggressively as the early intervention.

Original languageEnglish (US)
Pages (from-to)676-689
Number of pages14
JournalProblems in Urology
Volume4
Issue number4
StatePublished - Jan 1 1990

ASJC Scopus subject areas

  • Urology

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