Article

The urologist plays an important role in the multidisciplinary team of physicians
who provide care for patients with spina bifida. We review common strategies for
managing the urinary tract in these patients. The primary objective in all phases
of life is protecting kidney function by minimizing bladder hostility and
establishing a good capacity, low-pressure urinary reservoir. Ensuring adequate
bladder and bowel continence is also paramount for enhancing self-esteem and
independence. Medical therapy incorporating clean intermittent catheterization
and antimuscarinic medication is the cornerstone of neurogenic bladder management
and often the only intervention required to achieve the above goals. Others may
require formal lower urinary tract reconstruction to prevent urinary tract
deterioration. As will be shown, current management, while effective, is not
supported by strong evidence-based protocols; and the impact of any intervention
upon quality of life, while subjectively seen as positive, does not have
objective validation. These limitations are recognized and currently the subject
of urologic investigation.

Langue : ANGLAIS