Neurogenic Bladder

August 12, 2020
This podcast is an interactive discussion about Neurogenic Bladder between Dr. Rae Hanke, Dr. Lynn Woo, and Dr. Al Ray

Dr. Lynn Woo is an Associate Professor of Urology and Program Director at Case Western and Cleveland Medical Center. She is also a Pediatric Urologist at Rainbow Babies & Children's Hospital.

Dr. Al Ray is a urology PGY-4 at Case Western and currently on his research year.

Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

Dr. @lynnlwoo & Dr. Al Ray from @CaseUrology


  • Introduction (00:00)
  • Why is it important that pediatric surgeons are familiar with the management of Neurogenic Bladder? (01:00)
  • Case based questions (02:20)
  • You consult on a 1 day old female who is found to have myelomeningocele. What is your approach for the initial evaluation of the patient? (02:25)
  • How you decide when to initiate intermittent catheterization and what factors are you using to base this decision? (09:15)
  • Are there issues you should absolutely be intermittent catheterizing? (14:17)
  • What is the approach to counseling the parents of the patients and discussing goals of the patients care? (15:15)
  • How are the patients managed with so many disciplines working together? (17:40)
  • We have a patient thats now 4 months old, intermittent catheterization going well, no further urinary tract infection. Would you get any further testing now that this patients a little older? (20:06)
  • 1 year child compliant with catheterization and medication but urodynamics show bladder pressure greater than 40cm of water. What is going through your mind and how are you adjusting management for the child? (24:30)
  • If the patient has additional findings such as high grade reflux or recurrent UTI's would that be an indication to do something more aggressive or choose a different route for this patient? (27:19)
  • Vesicostomy a temporizing measure. When do you decide to take it down? Do you continue to follow that patient. (31:40)
  • You have a 5 year old female with Neurogenic Bladder. Starting school parents want better control over her continence. She leaks despite intermittent catheterization and Oxybutynin. (32:50)
  • Surgical options for incontinence. (40:20)
  • Parents of 5 year old dont want to move forward with surgery for incontinence. What are some options other then full reconstruction? (45:30)
  • What are some challenges of transitioning from child care center to an adult clinic?? (48:00)
  • Key takeaways. (52:30)

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