NEUROGENIC BLADDER

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Last Updated : 1/3/2011
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Kumud P Mehta
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Management of neurogenic bladder is complex and needs a team approach. In a common situation such as meningomyelocele pediatric urologist, nephrologist neurophysician, physiotherapist, radiologist with dedication are required for the comprehensive treatment.

Management includes:
- Prevention and control of urinary tract infection with appropriate long term drug therapy.
- Clean intermittent catheterization to evacuate bladder completely is advocated to reduce backpressure and prevent residual urine. Parents can be trained to perform CIC 3-4 times a day at home.
- Use of drugs to relax hypercontractile detrusor muscle ex. Oxybutynin or to increase contraction of hypocontractile bladder muscles use of cholinergic agents like Bethanachol can help to certain extent. Relaxation of urethral sphincter may be different and alpha blockers like prazosin may be useful. These drugs should be used after urodynamic evaluation by experts.
- Rarely in selected cases surgery is indicated to augment the bladder capacity and or tighten the urethral sphincter.
- Bladder training programs using biofeed methods should be tried.



Contributor Information and Disclosures Kumud P Mehta
Consultant Pediatrician & Pediatric Nephrologist, Jaslok Hospital & Research Centre, Bai Jerbai Wadia Hospital for children, Mumbai, India


First Created : 1/3/2001
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