Botox is now an option for help with bladder management in young patients with spina bifida and is growing as a preferred treatment over the traditional augmentation cystoplasty.

While data to back up either trajectory has been week,  a retrospective survey from Vanderbilt University Medical Center offers fresh clues to the decision-making process.

Pediatric urologist Douglass Clayton, MD led the work, which identified some major factors that can determine the way forward.

"It was really the quality-of-life measures that led families to want to pursue these larger reconstructive surgeries versus the more conservative option," Clayton said.