Related Experiment Videos
Initial experience with the transurethral self-detachable balloon system for urinary incontinence in pediatric
D A Diamond1, S B Bauer, A B Retik
1Department of Urology, Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Insights
This study explored a new endoscopic balloon treatment for pediatric urinary incontinence. The minimally invasive outpatient procedure showed encouraging results, particularly for patients with neurogenic causes who had not undergone prior surgery.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Endourology
Background:
- Urinary incontinence in children can stem from intrinsic sphincter deficiency.
- Neurogenic etiologies, such as myelomeningocele, are common causes.
- Previous surgical interventions may impact treatment outcomes.
Purpose of the Study:
- To evaluate a novel endoscopic technique for treating pediatric urinary incontinence.
- To assess the efficacy of a self-detachable balloon device in children with intrinsic sphincter deficiency.
Main Methods:
- Eleven pediatric patients with intrinsic sphincter deficiency underwent endoscopic balloon placement.
- The procedure was performed on an outpatient basis, with an average of 5 balloons per patient.
- Urodynamic studies were conducted pre- and post-procedure to assess efficacy.
Main Results:
- Seven of nine patients without prior bladder neck surgery showed improved urodynamic parameters.
- Four patients experienced marked clinical improvement, with two becoming completely dry.
- Patients with prior bladder neck surgery had less favorable outcomes.
Conclusions:
- The transurethral self-detachable balloon system offers a promising, minimally invasive outpatient option for pediatric urinary incontinence.
- The technique appears most suitable for patients with neurogenic incontinence who have not had previous surgery.
Purpose:
A new endoscopic technique to treat urinary incontinence in children using a self-detachable balloon device was studied.
Materials And Methods:
The study includes 11 patients with a mean age of 14.6 years and all of whom had intrinsic sphincter deficiency due to myelomeningocele in 9, spinal artery bleed in 1 and cloacal exstrophy in 1. All patients were on clean intermittent catheterization preoperatively and postoperatively. Endoscopic balloon treatment was performed on an outpatient basis. A mean of 5 balloons (range 2 to 8) were placed per patient. All patients underwent formal urodynamic study preoperatively and at 6 weeks and 6 months following balloon placement.
Results:
Of the 9 patients without prior bladder neck surgery 7 had improvement in urodynamic parameters, including urethral pressure profile in all 7 and functional bladder capacity in 6, 4 were markedly improved clinically and 2 were dry. Two patients with prior bladder neck surgery were clinically unchanged following balloon placement, although 1 had urodynamic improvement.
Conclusions:
Our initial experience with the transurethral self-detachable balloon system as a minimally invasive outpatient procedure to treat urinary incontinence in children has been encouraging. To date this procedure appears most applicable to the patient who has not undergone surgery and has a neurogenic etiology for urinary incontinence.