Zickler CF, Richardson V: Achieving continence in children with neurogenic bowel and bladder. J Pediatr Health Care 2004:18(6): 276-83.
Children born with myelomeningocele have both sensory and motor impairments, making toilet training very difficult. This article reviews neural tube abnormalities, physiologic process of micturition and bowel evacuation, the examination of the child, diagnostic tests to assess kidney and bladder function, and management including medications and surgical procedures. The advent of clear, intermittent catheterization, regular bowel routines, eating a balanced, varied diet (including high fiber, high fluid, balanced nutrients), new and innovative surgeries, and antispasmodic medications have helped to keep bladder function free of kidney damage and allow children some degree of independence and body control.