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Related Experiment Videos

Failed bladder neck reconstruction: options for management.

J P Gearhart1, D A Canning, R D Jeffs

  • 1Division of Pediatric Urology, James Buchanan Brady Urological Institute, Baltimore, Maryland.

The Journal of Urology
|October 1, 1991
PubMed
Summary
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Persistent urinary incontinence after bladder neck reconstruction can be successfully treated. Salvage procedures, including repeat reconstructions and augmentation cystoplasty, can achieve social continence in children with bladder exstrophy or epispadias.

Area of Science:

  • Pediatric Urology
  • Reconstructive Surgery

Background:

  • Persistent urinary incontinence is a challenge in patients with bladder exstrophy or epispadias.
  • Previous bladder neck reconstruction (BNR) procedures may fail, necessitating further intervention.

Purpose of the Study:

  • To evaluate the efficacy of salvage procedures for urinary incontinence after failed BNR.
  • To assess the long-term outcomes of reconstructive surgery in children with complex lower urinary tract anomalies.

Main Methods:

  • Retrospective review of 17 patients with persistent urinary incontinence post-BNR.
  • Analysis of salvage procedures including repeat Young-Dees-Leadbetter (YDL) BNR, augmentation cystoplasty, continent abdominal stoma creation, and artificial urinary sphincter (AUS) implantation.

Main Results:

Related Experiment Videos

  • Repeat YDL BNR achieved dryness for >=3 hours in 7/8 patients, with 1 requiring pads during strenuous activity.
  • Augmentation cystoplasty with adjunctive procedures resulted in continence for >=3 hours in 8/9 patients, with 6 achieving nighttime dryness.
  • One patient remained incontinent after AUS removal.

Conclusions:

  • Salvage reconstructive surgery can restore social continence in children with previously failed BNR.
  • Persistence and creative surgical approaches offer alternatives to urinary diversion for complex cases.