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Endoscopic treatment of urinary incontinence in children with primary epispadias
1Great Ormond Street Hospital for Children NHS Trust, Institute of Urology, Middlesex Hospital, London, UK.
Insights
This study explored polydimethylsiloxane particles (MPQ) for treating urinary incontinence in boys with epispadias. Preliminary results show it is an encouraging, minimally invasive option for improving continence.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Biomaterials
Background:
- Urinary incontinence in boys with epispadias presents a significant clinical challenge.
- Previous treatments often involve complex surgical interventions.
Purpose of the Study:
- To assess the efficacy of endoscopic submucosal injection of polydimethylsiloxane particles (MPQ) for treating urinary incontinence.
- To evaluate MPQ as a minimally invasive treatment option for boys with primary epispadias and incontinence.
Main Methods:
- 12 boys (aged 3-7 years) with persistent urinary incontinence post-epispadias repair underwent endoscopic submucosal injection of MPQ into the posterior urethra.
- The procedure involved 24 injections with a total volume of 83 mL of MPQ across 59 sites.
- Mean follow-up was 10.8 months.
Main Results:
- Three patients (25%) achieved complete dryness.
- Six patients (50%) showed improvement in their degree of incontinence.
- Three patients (25%) had no change in their incontinence status.
Conclusions:
- Endoscopic injection of MPQ is a promising, relatively non-invasive treatment for urinary incontinence in this patient group.
- Further investigation is warranted to optimize outcomes and long-term efficacy.
Objective:
To evaluate the efficacy of the endoscopic insertion of polydimethylsiloxane particles (Macroplastique, Uroplasty Inc) (MPQ) into the posterior urethral region of boys with urinary incontinence and primary epispadias.
Patients And Methods:
Between 1991 and 1995, 12 boys aged 3-7 years (mean 4.8) received an endoscopic submucosal injection with MPQ into the posterior urethra to correct urinary incontinence; the 12 boys were wet day and night. All patients had undergone a modified Cantwell epispadias repair before injection. The procedure was performed 24 times with a total volume of 83 mL of material injected into 59 sites in the posterior urethra (mean volume per injection 1.4 mL). The mean follow-up after injection was 10.8 months (range 3-22).
Results:
Three patients became completely dry, the degree of incontinence was improved in six and there was no change in three.
Conclusion:
The preliminary results of this relatively non-invasive treatment are encouraging.