Birth defects of the spinal cord

Most of the children born with spina bifida have neurogenic bladder (urination problems caused by neurological conditions).

For children with spina bifida, neurogenic bladder occurs because the spinal cord nerves that control the bladder didn't form properly. This causes issues with storing urine or emptying the bladder, or both.

Children with this condition generally require lifelong use of clean intermittent catheterization to protect their kidneys, prevent urinary tract infections.

Medication called anticholinergic is given to help relax the bladder, so it can store more urine, and also protect the kidneys.

Most children with spina bifida have constipation because the nerves that regulate bowel function often don't form properly.

Patients with spina bifida may have constipation, and they are given a laxative to promote regular bowel movements.

Many have a poor functioning bladder or a bladder that does not grow properly. When catheterization and medication aren't enough, some children may need bladder augmentation surgery. This procedure uses a piece of the small intestine to make the bladder bigger.

Sometimes they have difficulty in controlling bowel movements. Many patients achieve stool continence using a strict bowel program involving medication and "potty sits." If these methods are not successful, then an antegrade continence enema (ACE) procedure might be done.

For babies:

• Babies with spina bifida undergo their first urodynamic evaluation (testing of urinary function) after birth. The test is again performed periodically to evaluate bladder functioning and determine whether the given bladder treatments are working properly.
• An ultrasound imaging test is done for the kidney and bladder to ensure the treatments given are sufficient.
• Post void residual. This is performed by catheterizing the baby and measuring the amount of urine left in the bladder.
• Urinalysis or urine culture

For infants:

• Close monitoring is done during the first year
• Ultrasounds/ urodynamic studies are done every 3 to 6 months. It is done because there will be changes in how the bladder is working as the baby grows and the nerves and spinal cord develop