ABSTRACT
Neurologic lesions that affect lower urinary tract function cause at least 25% of the more severe clinical problems in pediatric urology. The advent of clean intermittent catheterization (CIC), introduced in the early 1970s by Lapides,1 and the refinements in the techniques of urodynamic studies in children,2-4 dramatically changed the way these children were managed.5 As a result, a greater understanding of the pathophysiology of the many diseases that primarily affect children coupled with improved functional assessment of the lower urinary tract has changed the thinking regarding treatment options.6,7 Once it was realized that urodynamic studies could define children at risk for urinary tract deterioration, early aggressive and even proactive therapy became the mainstay of management. Urodynamic testing is discussed in Chapter 51.
