ABSTRACT
A change in prognosis occurred in a step-wise manner in the second half of the twentieth century. Initially, improved obstetric and neonatal care resulted in an increase of surviving myelomeningocele (MMC) children by the end of the first half of the twentieth century. A new phase may have been entered since the recognition of the role of folic acid supplementation for all women of childbearing age as an important measure in the prevention of neural tube defects. The primary goal in the management of MMC patients is the preservation of kidney function. To achieve this goal, the bladder should function as a low-pressure reservoir. Obstructive uropathy and high bladder pressures during a significant part of the filling phase are the most important causes of kidney failure in these patients. An unsolved problem of urinary incontinence may have a serious impact on quality of life of the adult MMC patient.
