Conservative nonsurgical management of spina bifida.
The nonsurgical management of patients with spina bifida is predicated on maintaining a compliant bladder of adequate size or correcting detrusor sphincter dyssynergy that can lead to progressive bladder damage and ultimately upper tract changes. Pharmacologic management, targeted at the detrusor and/or external sphincter, can be done. Neuromodulation using transcutaneous approaches with interferential electrostimulation, sacral (S2-S3) via digital transcutaneous electrical nerve stimulation, and percutaneous tibial nerve stimulation all have shown varied successes.
Carr
Michael C
MC
Division of Urology, Children's Hospital of Philadelphia, Wood Center, 3rd Floor, 34th Street and Civic Center Boulevard, Philadelphia, PA, 19104, USA. carr@email.chop.edu
D018680:Cholinergic Antagonists / Q000008:administration & dosage*; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008297:Male; D016135:Spinal Dysraphism / Q000150:complications / Q000628:therapy*; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D001750:Urinary Bladder, Neurogenic / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D014549:Urinary Incontinence / Q000150:complications / Q000503:physiopathology / Q000628:therapy*
D018680:Cholinergic Antagonists