Myelomeningocele is the most common cause of neurogenic bladder dysfunction in children. The nature of the urinary tract dysfunction in myelomeningocele depends on the level and extent of the spinal cord lesion. Disruption of the neural axis between the pons and the sacral spinal cord by the myelomeningocele may cause a lack of coordination of the external bladder sphincter that causes involuntary sphincter activity during detrusor contraction. Myelomeningocele in the sacral area can produce a lower motor neuron lesion, resulting in a weakened bladder. These abnormalities may occur singly or in combination and typically result in incontinence and impaired bladder emptying that can lead to vesicoureteral reflux (the abnormal flow of urine from the bladder back into the ureters) and high-voiding pressures. If untreated, this condition can lead to potentially more serious complications, including frequent infections, upper urinary tract deterioration, and, ultimately, kidney failure (Liptak, 2004).