Neuropathic bladder Henrik A Steinbrecher, Padraig S Malone and Anthony MK Rickwood
Until the late 1950s, when the development of shunting devices to treat hydrocephalus led to the survival of large numbers of patients born with myelomeningocoele, neuropathic bladder was a rare disorder in children and received correspondingly little attention. Thereafter, unfortunately, it soon became apparent that children with myelomeningocoele presented with urological problems, as well as others, over and above those experienced by adults with spinal cord injury. The particular difficulties were:
• a preponderance of female patients, with evident implications for the management of incontinence
• a high incidence of secondary upper renal tract complications in patients of both sexes, although in boys more commonly.