THE IMPORTANCE OF CATHETER SIZE IN THE ACHIEVEMENT OF URINARY CONTINENCE IN PATIENTS UNDERGOING A YOUNG-DEES-LEADBETTER PROCEDURE

During the last 8 years 49 patients have undergone urinary tract recon struction at our institution to manage urinary incontinence. Of these patients 25 underwent a Young-Dees-Leadbetter procedure, of whom 13 bo ys and 6 girls were available for followup. Average patient age was 12 .2 years and mean followup is 30.2 months. Augmentation cystoplasty wa s required in 14 cases. All 12 patients (100%) undergoing tubularizati on over an 8F catheter attained diurnal continence, and 92% are comple tely continent day and night. Furthermore, the 6 patients in whom augm ent capacities attained were less than the expected volume for age wer e also completely continent when tubularization was performed over an 8F catheter. We conclude that creation of a narrow (8F) Young-Dees-Lea dbetter bladder neck tubularization leads to an increased likelihood o f diurnal and nocturnal continence but precludes spontaneous unaided v oiding to completion. Furthermore, achievement of urinary continence a ppears to be less dependent on bladder capacity when it is coupled wit h a narrow Young-Dees-Leadbetter tubularization.