Bladder neck closure for neurogenic incontinence

Some female patients with neurogenic bladders are treated by means of an indwelling urethral catheter, which, in the long term, commonly leads to marked urethral dilatation, such that, despite the use of larger catheters with bigger balloons bypassing incontinence occurs with distressing frequency. This problem has been overcome by operation to close the bladder neck and drain the bladder with a suprapubic catheter. Two techniques are described. Provided that there is correct catheter placement with unobstructed drainage, continence is total. Patients with sufficient dexterity have been taught to change their own catheters, and catheter problems have been nil. A technique for males is also described.