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  • Title: Sling suspension of the bladder neck for pediatric urinary incontinence.
    Author: Chrzan R, Dik P, Klijn AJ, de Jong TP.
    Journal: J Pediatr Urol; 2009 Apr; 5(2):82-6. PubMed ID: 18976960.
    Abstract:
    OBJECTIVE: Surgery for urinary incontinence in childhood is in the process of an ongoing search for better results because a procedure that guarantees dryness still does not exist. This study has been conducted to assess the overall results of the fascia sling procedure for incontinence in children. MATERIAL AND METHODS: Eighty-nine patients with neurogenic lower urinary tract dysfunction and follow-up of more than 2 years have been included in the study (46 boys and 43 girls aged 2-17 years). All patients underwent U-type sling suspension of the bladder neck. In 59 patients detrusorectomy and in 11 patients bladder augmentation was performed. Sphincter incompetence was defined as low-pressure (<30 cm H(2)O) leakage observed during urodynamic studies. The results of surgery were assessed clinically (dryness intervals). RESULTS: Forty-two (47%) patients were completely dry, and 23 (26%) considerably improved. The success rate was higher in males (35) than in females (30) (76% vs 70%). Detrusorectomy did not improve the success rate of the sling procedure (68% vs 79% sling only), but bladder augmentation did (90%). Higher success rates have been observed in adolescents compared to prepubertal children (83% vs 56%). No serious complications were observed. CONCLUSIONS: Rectus fascia sling suspension is a safe procedure and could be considered a good option for the treatment of neurogenic sphincter incompetence in children.
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