Management of neurogenic bladder in myelodysplasia patients: experience at our center

Abstract

Background Myelodysplasia is the term used for lesions include Spina bifida occulta, lipomeningocoele, meningocoele and meningomyelocele. meningomyelocoele is by far the most common disease of this group. These patients are commonly having neurogenic bladder. The treatment of neurogenic bladder is not so easy.[1] we are presenting our experience of 68 cases with neurogenic bladders. The aim of our study is to achieve continence and preserve upper urinary tract from further damage. There are a battery of investigations to assess these patients for eg. renal biochemistry, ultrasonography of the urinary tract, Micturating cysto-urethrogram,isotope renal scans, Clinical and bedside assessment, and Urodynamics.Tratment options available for these patients are drug therapy in the form of prophylactic antibiotics and anticholinergic drugs. Clean intermittent catheterization advocated by Lapides plays major role in the treatment of these patients [2]. Operative procedure perform in these patients are bladder neck reconstructions like, Young Dees Leadbetter and rectus sling.[3] High pressure bladder can be converted to low pressure bladder by using bladder augmentation procedures. Bladder augmentation procedures are increasing bladder capacity also thus improving dry intervals. Continent urinary diversion can be done by using appendix [4] and segment of ileum [5]. Once these patients achieve social or urinary continence follow up is very important.