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The treatment of children and adolescents with meningomyelocele has experienced a clear change in the last 30 years. The establishment of pharmacotherapy, clean intermittent catheterization (CIC) and infection prophylaxis have improved the prognosis for patients and have led to new therapeutic strategies. The interdisciplinary cooperation between neonatologists, neurosurgeons, pediatric neurologists, pediatric urologists, pediatric nephrologists, pediatric orthopedists and pediatric surgeons leads to optimization of individualized therapy. These guidelines present definitions and classifications, investigations and timing which are described in detail. The conservative and operative therapy options for neurogenic bladder function disorders are described and discussed with reference to the current literature. The brief overview provides in each case assistance for the treating physician in the care of this patient group and facilitates the interdisciplinary cooperation. [ABSTRACT FROM AUTHOR]

Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

With the objective of developing a biodegradable ureteric stent, various polylactides were analyzed and grafted with a clinically adapted surface. Stent moulding was performed by CESP technology (Controlled Expansion of Saturated Polymers), which is not based on high temperature but gas-loading under high pressure which induces a foamy bulk structure. The hydrolytically biodegradable, synthetic homo- and copolymers poly(D,L-lactide) (PDLLA), poly(D,L-lactide-co-trimethylene-carbonate) (PDLLA-co-TMC), poly(D,L-lactide-co-glycolide) (PDLLA-co-Gly) as derivatives of lactic acid or glycolic acid and surface modifications with hydroxyethylene-methacrylate (HEMA) and oligoethyleneoxidemonomethacrylate (OEOMA) were analyzed with regard to cytotoxicity and cell adhesion. Methacrylates have minimized protein and cell adhesion and degradation of non-toxic products. All polymers exhibited a high degree of biocompatibility and cell adhesion was markedly reduced following HEMA grafting. A 3 cm and 7 Charrière prototype of the stent was moulded from PDLLA-co-TMC by CESP-technology, and grafted with HEMA by means of plasma-induced polymerization. Finally, the stents were implanted into female sheep, following unilateral ureterotomy. Regular blood and urine analysis as well as ultrasound and the final autopsy revealed no pathological findings. Histopathological analysis exhibited a regular epithelium without any changes being determined by contact to the stent, and a good regeneration of all layers in the area of anastomosis. [ABSTRACT FROM AUTHOR]

Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)