Initial experience with the transurethral self-detachable balloon system for urinary incontinence in pediatric patients

Purpose: A new endoscopic technique to treat urinary incontinence in childr en using a self-detachable balloon device was studied. Materials and Methods: The study includes 11 patients with a mean age of 14 .6 years and all of whom had intrinsic sphincter deficiency due to myelomen ingocele in 9, spinal artery bleed in I and cloacal exstrophy in 1. Al pati ents were on clean intermittent catheterization preoperatively and postoper atively. Endoscopic balloon treatment was performed on an outpatient basis. A mean of 5 balloons (range 2 to 8) were placed per patient. All patients underwent formal urodynamic study preoperatively and at 6 weeks and 6 month s following balloon placement. Results: Of the 9 patients without prior bladder neck surgery 7 had improve ment in urodynamic parameters, including urethral pressure profile in all 7 and functional bladder capacity in 6, 4 were markedly improved clinically and 2 were dry. Two patients with prior bladder neck surgery were clinicall y unchanged following balloon placement, although I had urodynamic improvem ent. Conclusions: Our initial experience with the transurethral self-detachable balloon system as a minimally invasive outpatient procedure to treat urinar y incontinence in children has been encouraging. To date this procedure app ears most applicable to the patient who has not undergone surgery and has a neurogenic etiology for urinary incontinence.