Assessment and conservative management of the neuropathic bladder.
The etiologies and forms of congenital neuropathic bladder are described: contractile (25%), acontractile (15%), and intermediate (60%). The terminology relating to neuropathic bladder is defined and the principles of bladder management are highlighted: (1) must achieve a bladder that can fill at low pressure, (2) must achieve a bladder that can store urine at low pressure, (3) must achieve sphincter resistance that is sufficient to allow urine storage, and (4) must put in place a mechanism of achieving complete voluntary bladder emptying. The approach to investigation is set out in a logical sequence, and the methods of achieving the goals highlighted above are described. All of this is put in the context of managing the handicapped patient as a whole. It also is stressed that the aim is not just to achieve continence but perhaps even more importantly to protect renal function.
Rickwood
A M K
AM
Alder Hey Children's Hospital, Liverpool, England.
D001559:Benzhydryl Compounds / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D003408:Cresols / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008333:Mandelic Acids / Q000008:administration & dosage; D008591:Meningomyelocele / Q000150:complications; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D010665:Phenylpropanolamine; D000068737:Tolterodine Tartrate; D001750:Urinary Bladder, Neurogenic / Q000145:classification / Q000209:etiology / Q000628:therapy*; D014546:Urinary Catheterization / Q000379:methods
D001559:Benzhydryl Compounds; D018680:Cholinergic Antagonists; D003408:Cresols; D008333:Mandelic Acids; D018727:Muscarinic Antagonists; D010665:Phenylpropanolamine; D000068737:Tolterodine Tartrate; C005419:oxybutynin