Recent years have seen significant advancements in the treatment of myelomeningocele patients, particularly in terms of renal preservation and continence. Many advancements in preventative care and early intervention have been spurred by urologists’ involvement both prenatally and early in life. However, the best therapy strategy for these individuals that involves the least amount of invasive diagnostic tests and therapies while yet protecting renal and bladder function is still unknown.
In a departure from previous years, when surgical intervention and intermittent catheterization were used more liberally, some clinicians recently pushed for more cautious surveillance of patients using a variety of diagnostic testing until radiographic or clinical alterations were identified. In pediatric urology, the criteria used to determine the necessity for catheterization and the scheduling of CIC or more invasive procedures differ, and there was published data to support many approaches.
In this review, researchers discussed some of the criteria for using CIC, as well as some fresh data to support various methods, as well as the move toward customized medicine and the use of risk stratification in constructing clinical treatment algorithms.