[The treatment of vesicoureteral reflux in children with myelomeningocele].
OBJECTIVE
To perform a bibliographic review on the topic of vesicoureteral reflux (VUR) in children with myelomeningocele.


METHODS
PubMed search using the terms: vesicoureteral reflux and myelomeningocele.


RESULTS
Between 1981 and 2007 340 articles were found, 61 of which were considered adequate, and 48 were used as references for this monographic issue. We discuss the pathogenesis of VUR in neurogenic bladder, the efficacy of conservative treatment with clean intermittent catheterization and anticholinergic drugs, as well as the indications and efficacy of various surgical procedures including ureteral reimplantation, subureteral injection of various agents, bladder augmentation, cutaneous vesicostomy, urethral dilation, transureteral-ureterostomy and botulin toxin injection.


CONCLUSIONS
Vesicoureteral reflux plays an important role in the development of renal damage in infants and children with congenital myelomeningocele. Nephropathy may be prevented with adequate evaluation and follow-up and timely therapeutic intervention. Renal failure in these patients always reflects the failure of medical care or social/socioeconomic conditions.
González
Ricardo
R
Urología Pediátrica, Al DuPont Hospital for Children, Thomas Jefferson University, Wilmington, Delaware 19899, USA. ricardo_gonzalez33154@yahoo.com
Ludwikowski
Barbara M
BM
D002648:Child; D006801:Humans; D008591:Meningomyelocele / Q000150:complications*; D014718:Vesico-Ureteral Reflux / Q000209:etiology* / Q000628:therapy*