COMBINED BLADDER NECK SUSPENSION AND AUGMENTATION CYSTOPLASTY FOR NEUROPATHIC INCONTINENCE IN FEMALE-PATIENTS

Objective To perform bladder neck suspension simultaneously with augme ntation cystoplasty in female patients where sphincteric incompetence was not the sole cause of impaired functional bladder capacity. Patien ts and methods During an 8-year-period, 26 female patients (mean age 1 4, range 5-39) were treated with a Marshall-Marchetti plus cystoplasty (Liverpool) or a colposuspension plus clam cystoplasty (Sheffield). A ll had marked sphincteric incompetence compounded by detrusor hyper-re flexia and/or noncompliance. The patients were followed up for a mean period of 30 months (range 8-80). Results There were no major complica tions. At followup 23 (88%) were dry by day on a regime of intermitten t self-catheterization. Nine patients were taking adjuvant medication, usually for prevention of nocturnal enuresis. Conclusion The results compare tolerably with those of all alternative procedures, including the more elaborate reconstructions (e.g. Kropp procedure) and the expe nsive artifical urinary sphincter.