Evaluation and treatment of children with neurogenic bladders

The evaluation and treatment of children with neurogenic bladders can be di fficult because of the complexity of the neurologic deficit and the subject ivity of the history and physical exam. The primary emphasis of the physici ans caring for these children should be to preserve renal function and faci litate continence when possible. As knowledge of both normal and abnormal l ower urinary-tract dynamics increases, so does the ability to care for chil dren with abnormal bladder dynamics caused by various neurologic conditions . With recent advancements in medical and surgical treatment of the neuroge nic bladder, most children can maintain adequate renal function and attain urinary continence. This article reviews the pertinent innervation, anatomy , and physiology of the lower urinary tract, and discusses current evaluati on and treatment of children with neurogenic bladders.