Each of these conditions may lead to its own set of problems, including visual impairment, bowel or bladder incontinence, deterioration in renal function, lack of mobility, and skin breakdown. Families, in conjunction with their primary care provider and school nurse, play a major role in the prevention of complications and the promotion of health and positive self-esteem in the child with spina bifida. Bowel and bladder complications usually occur with myelomeningocele. Even myelomeningoceles in the low lumbar and sacral areas have some degree bowel or bladder dysfunction because the nerves from this area supply those organs. There are physical problems associated with bladder incontinence, but the emotional issues related to bowel control with the associated, odor, lack of positive self-esteem, and poor body image can lead to severe social problems.
Bladder incontinence is approached mostly by a medical model.
Prevention of recurrent bladder infections is primary as kidney failure can cause death. Bowel training is not life threatening, and has more of a behavior management approach. Fecal incontinence in the school setting can be morally devastating to a school-aged child. Setting up a successful bowel management program can be one of the most important things in your child's life. Remember that no single thing works, and patience is needed to find the right combination.