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Bladder neck closure for treating pediatric incontinence.

P Hoebeke1, P De Kuyper, H Goeminne

  • 1Department of Pediatric Urology, University Hospital, Gent, Belgium. piet.hoebeke@rug.ac.be

European Urology
|October 12, 2000
PubMed
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Bladder neck closure (BNC) offers a high continence rate and excellent patient satisfaction for pediatric incontinence. This reconstructive surgery should be considered when other methods fail, with careful follow-up essential.

Area of Science:

  • Pediatric Urology
  • Reconstructive Surgery
  • Continence Management

Background:

  • Pediatric incontinence poses significant challenges, often requiring complex surgical interventions.
  • Previous reconstructive attempts for incontinence may fail, necessitating alternative strategies.

Purpose of the Study:

  • To evaluate the effectiveness of bladder neck closure (BNC) in achieving continence in pediatric patients.
  • To assess the quality of life and patient satisfaction following BNC.

Main Methods:

  • A retrospective review of 17 pediatric patients who underwent BNC with continent diversion over five years.
  • Data collected included prior surgeries, continence status, complications, and patient-reported satisfaction.
  • Continent diversion utilized appendix in 13 cases; bladder augmentation was performed in 13 patients.

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Main Results:

  • All patients achieved complete dryness post-BNC, with one experiencing transient nocturnal stomal incontinence that resolved.
  • Patient satisfaction was extremely high, with all participants content with the procedure and stoma.
  • Complications included urinary tract infections (9 patients) and stomal issues (8 patients), with most managed conservatively or with minor re-intervention.

Conclusions:

  • Bladder neck closure is a highly effective ultimate reconstructive option for pediatric incontinence, yielding superior continence rates.
  • The procedure demonstrates a favorable balance of high success, low complication rates, and significant patient satisfaction.
  • Close patient compliance and diligent upper urinary tract monitoring are crucial for long-term success.