Urologic Implications and Management in Spina Bifida

Abstract

Urological disorders, including urinary infections, incontinence, and renal failure, represent a significant source of morbidity and mortality in these patients. Long-term mortality is associated to urological causes in approximately 33%. In order to prevent this complications, urologic evaluation since early childhood must be done. The evaluation of the degree of damage to the urinary tract and the determination of the type of neurogenic bladder involved in the spina bifida spectrum will be the guideline for establishing therapeutic management, which can be from behavioral modifications, medical management, minimally invasive therapy and, as a last resort, surgery. In this chapter, we will discuss the wide spectrum of urologic implications, a brief reminder of urinary tract physiology and the pathological processes involved in spina bífida, as well as long-term complications. The diagnostic evaluation of urinary tract and the different therapeutic modalities according to the type of neurogenic bladder and age will be discussed.