UROLOGICAL COMPLICATIONS AND MANAGEMENT OF CONGENITAL NEUROGENIC BLADDER WITHOUT MENINGOMYELOCELE

Abstract

Congenital neurogenic bladder, not associated with meningomyelocele, is a relatively rare entity, distinctly different from the latter in its diagnosis, treatment, and complications. Herein, some problems of treatment and complications of our 21 cases, experienced in the last eight years, are reported. Of the 21 cases, 18 had spina bifida occluta, 11 sacral dysgenesis, 3 congenital scoliosis. There were 9 cases that had so-called “tethered cord syndrome” with occult spinal dysraphism. The chief complaints were urinary incontinence and symptoms of urinary tract infection. The cases of tethered cord syndrome were urologically managed like those of meningomyelocele, although the indication and timing of operation must be decided carefully. In the cases of sacral dysgenesis, association of various genitourinary and anorectal anomalies were characteristic. Urological management of these cases were more complicated than in meningomyelocele, since these assosiated anomalies often dictate the treatment plans.