Bladder Neck Closure for Treating Pediatric Urinary Incontinence.
- Author:
Kwang Myung KIM
1
;
Tae hun KIM
;
Sang Wook LEE
Author Information
1. Department of Urology, Seoul National University College of Medicine, Seoul, Korea. kwang@plaza.snu.ac.kr
- Publication Type:Original Article
- Keywords:
Urinary incontinence;
Bladder;
neurogenic;
Child
- MeSH:
Appendix;
Catheterization;
Catheters;
Child;
Constriction, Pathologic;
Fistula;
Follow-Up Studies;
Humans;
Ileus;
Neck*;
Urinary Bladder Calculi;
Urinary Bladder*;
Urinary Bladder, Neurogenic;
Urinary Incontinence*;
Urinary Tract Infections
- From:Korean Journal of Urology
2003;44(7):655-659
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Our aim was to evaluate the efficacy of a bladder neck closure (BNC) for the treatment of incontinence in children with a neurogenic bladder. MATERIALS AND METHODS: Between January 1995 and July 2002, 14 children (8 boys and 6 girls) underwent a BNC, with continent diversion. Information on the continence stati and complications following the BNC were evaluated. The mean age at the time of the operation and the follow-up period were 9.7 years, ranging from 6 to 22, and 21 months, respectively. All children suffered from neurogenic incontinence related to spinal bifida. The BNC were performed as primary procedures in 11 children and as secondary procedures in 3. During surgery, the bladder neck was transected and the bladder opening and urethral stump closed in two layers. A Mitrofanoff diversion, with appendix, was performed in all patients. RESULTS: After the BNC, all the patients were completely dry. As for the related complications with the BNC, no leakages or fistulae were seen in any of the patients. Bladder stones were seen in 2 patients, postoperative ileus in 2 and symptomatic urinary tract infection in 1. Stomal complications were seen in 2 patients. One patient each had some pain with the catheterization and mild stomal stenosis, but they all improved with no additional intervention. CONCLUSIONS: With the high success, and low complication, rates, it is concluded that a BNC, in conjunction with bladder augmentation and Mitrofanoff diversion, is highly efficacious in achieving dryness in pediatric urinary incontinence, when used as a primary, as well as a salvage procedure.
