Current Approaches to Evaluation and Management of Children with Myelomeningocele

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Abstract
The introduction of CIC and the artificial urinary sphincter have radically altered the management of the urinary tract in children with myelodysplasia. Supravesical urinary diversion is less often needed, although there is still a place for this treatment modality. When diversion is indicated, nonrefluxing intestinal conduits are suggested. The routine use of suprapubic bladder expression has only limited applicability. When possible, the child should undergo urodynamic study, and the family should be made aware of the treatment modalities available. Before proposing a urinary diversion on implantation of an artificial urinary sphincter, detailed explanations of the procedure and the alternatives must be given to parents and patients. This report was reviewed by the present and former members of the committee who have contributed to its contents.

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