The role of urethral dilation in managing pediatric neurogenic bladder dysfunction.

Urethral dilation is an effective method of treating children with neurogenic bladders who have poor bladder compliance, high leak point pressure, and are unresponsive to standard therapy with anticholinergic medications and clean intermittent catheterization. Urethral dilation can be successfully applied to boys and girls and has few side effects. There are no demonstrated long-term effects on continence. However, the use of urethral dilation has been limited by two factors: 1) general disregard given to urethral dilation when applied to children and adults with recurrent urinary tract infections and lower urinary tract symptoms, and 2) the general efficacy of conventional therapy that limits the number of children who may actually benefit from the procedure.