REVIEW ARTICLE: SURGICAL MANAGEMENT OF URINARY INCONTINENCE IN CHILDREN WITH NEUROGENIC SPHINCTERIC INCOMPETENCE

Abstract

No AccessJournal of UrologyPEDIATRIC UROLOGY1 Jan 2000REVIEW ARTICLE: SURGICAL MANAGEMENT OF URINARY INCONTINENCE IN CHILDREN WITH NEUROGENIC SPHINCTERIC INCOMPETENCE JOHN V. KRYGER, RICARDO GONZÁLEZ, and JULIA SPENCER BARTHOLD JOHN V. KRYGERJOHN V. KRYGER , RICARDO GONZÁLEZRICARDO GONZÁLEZ , and JULIA SPENCER BARTHOLDJULIA SPENCER BARTHOLD View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)68031-7AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: There are many alternatives for the surgical treatment of children with neurogenic sphincteric incompetence. However, there is no consensus regarding appropriate evaluation and long-term management in these patients. We critically reviewed the literature and compare the outcomes of each technique. Materials and Methods: A MEDLINE search was performed to select all relevant peer reviewed publications since 1966. In addition, the bibliography of each article was examined for additional published resources. The results of each technique were compared in 7 objective categories, including continence (defined as complete dryness for 4 hours between voidings or catheterizations), the need for intermittent catheterization, effects on bladder compliance, the need for bladder augmentation, upper tract changes, other complications and the revision rate. Results: Long-term results of artificial urinary sphincter placement were superior and reproducible in terms of continence, preservation of volitional voiding and avoidance of bladder augmentation. Revision rates of various procedures were similar but the incidence of complications was highest with the Kropp procedure. Long-term published data were limited in regard to bladder neck sling, reconstruction, injection, suspension and urethral lengthening techniques. Conclusions: Long-term published data support artificial urinary sphincter creation as first line surgical management of neurogenic sphincteric incontinence. Girls who already depend on intermittent catheterization may benefit equally from a sling procedure if successful long-term continence is demonstrated in future studies. References 1 : The urological fate of young adults with myelomeningocele: a three decade follow-up study. Eur Urol1997; 32: 213. Google Scholar 2 : Urodynamic evaluation of the continence mechanism following urethral lengthening—reimplantation and enterocystoplasty. J Urol1991; 146: 535. Link, Google Scholar 3 : Clean, intermittent self-catheterization in the treatment of urinary tract disease. J Urol1972; 107: 458. Abstract, Google Scholar 4 : Impact of an intermittent catheterization program on children with myelomeningocele. Pediatrics1985; 76: 892. Google Scholar 5 : Results of clean intermittent catheterization for children with neurogenic bladders. 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Volume 163Issue 1January 2000Page: 256-263 Advertisement Copyright & Permissions© 2000 by American Urological Association, Inc.Keywordsurinary sphincter, artificialmeningomyeloceleurinary incontinencebladder, neurogenicbladderMetricsAuthor Information JOHN V. KRYGER More articles by this author RICARDO GONZÁLEZ More articles by this author JULIA SPENCER BARTHOLD More articles by this author Expand All Advertisement PDF downloadLoading ...