ABSTRACT
I first met eight-year-old Christian when he was in a urological clinic for treatment and I was called in for consultation. He was suffering from a nonneurogenic neurogenic bladder with hydronephrosis of the right kidney. With Christian, as in other cases of neurogenic bladder dysfunction, chronic urinary dysfunction had led to trabeculation of the bladder and to a build-up of residual urine which was backing up to the kidney, with dilation of the urinary tracts. Because of these serious developments there was a threat of permanent damage to the kidneys with a risk of renal insufficiency. Urological treatment with biofeedback training of the pelvic floor had produced some initial success, but had then had no further effect. It had been necessary to insert a supra-pubic bladder catheter, i.e. to draw off the urine via a tube through the abdominal wall to prevent a build-up of urine and so save the kidneys.
