title: [Urological problems in patients with meningomyelocele. Diagnostic studies and management].
abstract: Since the 1980s the management of children and adolescents with meningomyelocele has undergone major changes. The introduction of pharmacotherapy with antimuscarinic agents, clean intermittent catheterization (CIC) and antibacterial prophylaxis has revolutionized the management of children with neurogenic bladder. The co-operation between neonatologists, neurosurgeons, paediatric neurologists, paediatricians, paediatric urologists, paediatric nephrologists, paediatric orthopaedists and paediatric surgeons is necessary to achieve an optimized therapy in each individual patient. In this interdisciplinary consensus paper we provide definitions and classifications as well as a timetable for the appropriate investigations. The conservative and surgical options are explained in detail. A short review is given concerning orthopaedic management, incidence of latex allergy, options for bowel management, diagnosis and treatment of urinary tract infections, problems with sexuality and fertility as well as the long-term compliance of these patients and their relatives.
authors.affiliation: Urologische Klinik und Poliklinik, Klinikum der Johannes Gutenberg Universität, Langenbeck-Strasse 1, Mainz, Germany. Stein@urologie.klinik.uni-mainz.de
authors.forename: R
authors.initials: R
authors.lastname: Stein
authors.forename: A
authors.initials: A
authors.lastname: Schröder
authors.forename: R
authors.initials: R
authors.lastname: Beetz
authors.forename: A
authors.initials: A
authors.lastname: Ermert
authors.forename: D
authors.initials: D
authors.lastname: Filipas
authors.forename: M
authors.initials: M
authors.lastname: Fisch
authors.forename: M
authors.initials: M
authors.lastname: Goepel
authors.forename: I
authors.initials: I
authors.lastname: Körner
authors.forename: B
authors.initials: B
authors.lastname: Schönberger
authors.forename: C
authors.initials: C
authors.lastname: Sparwasser
authors.forename: M
authors.initials: M
authors.lastname: Stöhrer
authors.forename: J W
authors.initials: JW
authors.lastname: Thüroff
mesh_terms: D000293:Adolescent; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003299:Cooperative Behavior; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008403:Mass Screening; D008591:Meningomyelocele / Q000175:diagnosis* / Q000628:therapy; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D009436:Neural Tube Defects / Q000175:diagnosis / Q000628:therapy; D010348:Patient Care Team; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis* / Q000628:therapy; D053201:Urinary Bladder, Overactive / Q000175:diagnosis / Q000628:therapy; D014546:Urinary Catheterization; D014547:Urinary Diversion; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000628:therapy; D014563:Urodynamics / Q000502:physiology; D014570:Urologic Diseases / Q000175:diagnosis* / Q000628:therapy; D014718:Vesico-Ureteral Reflux / Q000175:diagnosis / Q000628:therapy
chemical_list: D000317:Adrenergic alpha-Antagonists; D018727:Muscarinic Antagonists