Surgical reconstruction for complete urinary incontinence: a 10 to 22-year followup

A 22-year followup study was performed on 27 children and 7 adults treated surgically for complete urinary incontinence. The etiology of the incontinence was iatrogenic, traumatic or congenital. The patients had undergone a urethral reconstruction that created a physiological sphincter by ureteral reimplantation and trigonal tubularization. Success was defined if a patient was dry with no leakage or stress urinary incontinence and partial success was noted if the patient wore 1 to 3 perineal pads per day that were moist to damp. Of 7 adults 4 (57 per cent) were dry and 2 (29 per cent) were considered a partial success, compared to 19 (70 per cent) and 1 (3 per cent), respectively, of 27 children. Postoperatively, no significant residual urine was present and the excretory urograms were normal. Failures and alternative treatments for failures are discussed.