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Related Experiment Videos

Experience with the Kropp anti-incontinence procedure.

A B Belman1, G W Kaplan

  • 1Department of Urology, Children's Hospital National Medical Center, Washington, D.C. 20010.

The Journal of Urology
|May 1, 1989
PubMed
Summary

The Kropp urethral lengthening and implantation procedure effectively treated neurogenic bladder dysfunction in 18 pediatric patients. Most patients achieved good to excellent results, resolving significant social incontinence issues.

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Area of Science:

  • Urology
  • Pediatric Surgery
  • Reconstructive Urology

Background:

  • Neurogenic bladder dysfunction significantly impacts quality of life in pediatric patients.
  • Failed conservative management, including clean intermittent catheterization and pharmacotherapy, necessitates advanced surgical interventions.
  • Urinary incontinence poses a considerable social challenge for affected children and adolescents.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of the Kropp urethral lengthening and implantation procedure in pediatric patients with neurogenic bladder.
  • To assess the procedure's success rate in achieving urinary continence and improving social function.
  • To report on the adjunctive use of augmentation cystoplasty and its impact on outcomes.

Main Methods:

Related Experiment Videos

  • Retrospective review of 18 patients (ages 6-19) with neurogenic bladder dysfunction undergoing the Kropp procedure.
  • Patients had failed prior treatments, including clean intermittent catheterization and, in some cases, artificial urinary sphincter.
  • Augmentation cystoplasty was performed in 14 patients using various bowel segments; 4 patients did not undergo augmentation.

    • Main Results:

    • 17 out of 18 patients achieved good results, with 14 considered excellent outcomes.
    • The single failure occurred in a patient with a history of failed artificial urinary sphincter placement.
    • 3 of 4 patients not undergoing augmentation required anticholinergic medication for continence.

    Conclusions:

    • The Kropp urethral lengthening and implantation procedure is a highly effective surgical option for managing neurogenic bladder dysfunction in pediatric patients.
    • The procedure offers a high success rate in achieving urinary continence, significantly improving patients' social well-being.
    • Augmentation cystoplasty can be a valuable adjunct, though some patients may achieve continence without it, potentially with medical support.