title: British Association of Paediatric Urologists consensus statement on the management of the neuropathic bladder.
abstract: BACKGROUND
  A large number of children with spina bifida develop a neuropathic bladder and this group of patients still forms the largest group of children who require urological management. Although there are published guidelines on the management of the neuropathic bladder, they are not specific to children. It is unsurprising, therefore, that the initial investigation, assessment and management of children with spina bifida vary considerably. The 2014 British Association of Paediatric Urologists (BAPU) meeting was devoted to the management of the neuropathic bladder. The aim was to produce a consensus on the appropriate investigation and management of a child with a neuropathic bladder.
  
  
  METHODS
  A questionnaire was devised and the members were polled on their current practice. Six paediatric urology fellows presented an evidence-based literature review on different aspects of the neuropathic bladder. At the end of the session, the members of the organisation present were polled again using the same questions.
  
  
  RESULTS
  The BAPU felt that the use of urodynamics in the neuropathic bladder should be selectively determined by clinical parameters. Regarding CIC, the group was evenly split between universal use or only when poor emptying was established. Oxybutinin was the first-line anticholinergic of choice. Most paediatric urologists routinely used Botox and were happy to use it repeatedly. The surgical intervention most frequently employed was determined to be an ileocystoplasty, with most surgeons deferring the need for surveillance cystoscopy until at least 10 years after surgery.
  
  
  CONCLUSIONS
  It was felt that a consensus statement is not a guideline or a way to establish best practice; however, it serves as a way of surveying current practice and providing a benchmark for clinicians involved in the management of these patients.
authors.affiliation: Department of Paediatric Surgery and Urology, Royal Hospital for Children, Glasgow, UK.
authors.forename: B
authors.initials: B
authors.lastname: Lee
authors.affiliation: Department of Paediatric Surgery and Urology, Great Ormond Street Hospital for Sick Children, London, UK.
authors.forename: N
authors.initials: N
authors.lastname: Featherstone
authors.affiliation: Department of Paediatric Urology, Royal Manchester Children's Hospital, Manchester, UK.
authors.forename: P
authors.initials: P
authors.lastname: Nagappan
authors.affiliation: Department of Paediatric Urology, Birmingham Children's Hospital, Birmingham, UK.
authors.forename: L
authors.initials: L
authors.lastname: McCarthy
authors.affiliation: Department of Paediatric Surgery and Urology, Royal Hospital for Children, Glasgow, UK. Electronic address: stuart.o'toole@ggc.scot.nhs.uk.
authors.forename: S
authors.initials: S
authors.lastname: O'Toole
mesh_terms: D002648:Child; D019468:Disease Management; D006801:Humans; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D001750:Urinary Bladder, Neurogenic / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000592:standards*; D000072178:Urologists / Q000706:statistics & numerical data*; D014572:Urology / Q000592:standards
keywords: Anticholinergics; Augmentation; Botolinum toxin A; Neuropathic bladder; Surveillance