BLADDER WALL PEDICLE WRAPAROUND SLING FOR NEUROGENIC URINARY-INCONTINENCE IN CHILDREN

Purpose: To improve the results of current bladder neck reconstruction a modification was developed to provide tapering, circumferential com pression and suspension of the bladder neck. Materials and Methods: Ni ne female and 15 male patients with spinal dysraphism and incontinence , despite intermittent catheterization and pharmacotherapy, and low ou tlet resistance underwent surgery, The procedure involves wrapping a p edicle strip of anterior bladder wall around the bladder neck and susp ending it to the pubic symphysis. Results: All 9 girls are completely continent, whereas 10 boys are dry and 5 have stress incontinence afte r 9 to 14 months of followup. Subjective symptoms correlate with chang es in leak point pressure. Conclusions: This technique is an efficacio us addition to bladder augmentation in female patients with poor compl iance and low outlet resistance.