Bladder neck and pelvic floor suspension for neurogenic urinary incontinence in children / 中华泌尿外科杂志

ABSTRACT

Objective To assess the effect of bladder neck sling in combination with pelvic floor suspension for management of urinary incontinence due to neurogenic sphincter incompetence in children. Methods From March 1998 to October 2000,23 patients (age5 14 years) with neurogenic urinary incontinence resulting from congenital myelodysplasia underwent bladder neck sling with pyramidalis muscle in combination with pelvic floor suspension with iliopsoas,of whom 14 patients underwent bladder augmentation concomitantly with the procedure. Results All patients were followed up for 5 to 32 months (mean 18 months).Thirteen cases achieved continence,7 cases were improved,and 3 failed to gain effect.The overall effective rate was 87%.Pre operatively,the maximum bladder volume were (151.5?72.8)ml,leak point pressure were (32.3?6.5)cm H 2O(1 cm H 2O=0.098 kPa),maximum urethral pressure were ( 38.4 ? 13.7 )cm H 2O,maximum closing pressure were (22.8?13.2)cm H 2O and functional urethral length were (3.9?1.8)cm respectively.Post operatively,they were (211.6?63.3)ml,(49.8?16.4)cm H 2O,( 50.8 ?12.3)cm H 2O,(32.9?12.5)cm H 2O,(5.6?2.0)cm correspondingly.The differences were significant ( P