Congenital neuropathic bladder

Abstract

Since the mid-portion of the 2nd decade of the twentieth century, there has been a paradigm shift in the evaluation and management of newborns with myelodysplasia due to the successful development of prenatal closure of the spinal defect [ 1 ]. The improved cognitive ability with the apparent reduced need for shunting the cerebrospinal fl uid in these infants is driving families and practitioners to seek prenatal treatment of the defect at an expanding number of locations around the USA. Although defi nitive urologic fi ndings from the largest series of prenatal closures (the MOMS trial) have not been published yet, several reports involving small groups of these children have shown that the neuro-urologic fi ndings may differ in these infants from newborns closed postnatally [ 2, 3 ]. It is imperative, therefore, that newborns who have had prenatal closure undergo lower urinary tract assessment as soon as feasible after delivery to characterize its function and then apply treatment based on the algorithm outlined in this chapter.