ONE OF the most perplexing problems confronting the surgical staff of the Children's Hospital is the care of those youngsters who have congenital abnormalities of the lumbosacral portion of the spinal cord and consequent neuromuscular defects of the bladder and anal sphincters, which cause constant urinary and fecal soiling. While some of these children have normal, or near-normal, sensation and motor power of the legs, others have neuromuscular defects of marked degree in the lower extremities. Therefore the problem of urinary or fecal soiling of the perineum and thighs is doubly troublesome and disagreeable because the subject must wear leg braces, use crutches, or be handicapped in his locomotion and thereby unable to cleanse and care for himself properly. These children are wet, smelly, and uncomfortable; they rapidly become outcasts. Constantly soiled by their own excretions, they lead miserable lives, often are bedridden, and present such difficult and protracted nursing