Conservative bladder treatment in myelodysplasia. Differentiation of patients by cystomanometry.
Urodynamic evaluation was performed in 75 patients with congenital neuropathic bladder. Concerning treatment the most important parameters were detrusor tone, detrusor activity and bladder outlet resistance. Based on these findings individual conservative therapy was applied. Reflux or dilatation of the upper urinary tract found in 26 children could be controlled by drugs or transurethral operations in 20, urinary diversion had to be done only 4 times. 26 children were selected for intensive treatment of incontinence; in about 50% satisfying urinary control was achieved. These results still need long-term observation. The main interest, however, was to postpone irreversible surgery and to gain time for possible better treatment in the future.
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003106:Colon / Q000601:surgery; D003975:Diazepam / Q000627:therapeutic use; D004108:Dilatation, Pathologic / Q000209:etiology; D005260:Female; D006801:Humans; D007099:Imipramine / Q000627:therapeutic use; D007223:Infant; D008297:Male; D008365:Manometry; D010643:Phenoxybenzamine / Q000627:therapeutic use; D000644:Quaternary Ammonium Compounds / Q000627:therapeutic use; D013116:Spinal Cord / Q000002:abnormalities; D013118:Spinal Cord Diseases / Q000150:complications; D014515:Ureteral Diseases / Q000209:etiology; D001743:Urinary Bladder / Q000503:physiopathology*; D001748:Urinary Bladder Neck Obstruction / Q000188:drug therapy; D001750:Urinary Bladder, Neurogenic / Q000151:congenital* / Q000188:drug therapy / Q000601:surgery; D014547:Urinary Diversion; D014549:Urinary Incontinence / Q000188:drug therapy; D014718:Vesico-Ureteral Reflux / Q000209:etiology
D000644:Quaternary Ammonium Compounds; D010643:Phenoxybenzamine; D007099:Imipramine; D003975:Diazepam