Current Approaches to Evaluation and Management of Children With Myelomeningocele*

The past five .yeans have brought considerable changes in the urologic management of children born with myelodysplasia. The most notable developments are clean intermittent cathetenization (CIC) with and without adjunctive surgery; decreased use of suprapubic bladder expression; general disenchantment with the long-term results of the refluxing uretenointestinal conduit diversions; artificial urinary sphincter implantation; use of neuropharmacologic agents to control urinary continence; new modalities in the investigation of neurogenic bladder dysfunction; and a multidisciplinary approach. An expansion of these items is included in a presentation of current approaches to evaluation and management of children with myelomeningocele.