Results of the rectus fascial sling and wrap procedures for the treatment of neurogenic sphincteric incontinence

被引:25
作者
Barthold, JS [1 ]
Rodriguez, E
Freedman, AL
Fleming, PA
González, R
机构
[1] Childrens Hosp Michigan, Dept Urol, Detroit, MI 48201 USA
[2] Wayne State Univ, Sch Med, Detroit, MI USA
关键词
urinary incontinence; bladder; urethra; abnormalities;
D O I
10.1016/S0022-5347(01)62131-1
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose: We assessed the early results of the rectus fascial sling and modified rectus fascial wrap for treating neurogenic sphincteric incontinence in a pediatric population. Materials and Methods: We retrospectively reviewed the charts of all patients who underwent a rectus fascial sling or wrap procedure for neurogenic incontinence at our institution. Most recent status was confirmed by telephone interview as successful-complete day and night dryness, partially successful-occasional daytime wetting and/or nocturnal enuresis and failed-frequent daytime incontinence. Results were analyzed with regard to patient sex, associated bladder augmentation and previous or subsequent anti-incontinence surgery. Results: A total of 27 patients underwent, 10 sling and 18 wrap procedures. Five patients in each group were dry after 1 to 4.5 years of followup. Six of the 7 boys were wet and 1 was partially dry postoperatively, while 10 of the 20 girls became dry (p = 0.026 Fisher's exact test), resulting in an overall 36% success rate. In failed cases continence was achieved after periurethral collagen injection and artificial urinary sphincter placement in 0 of 5 and 5 of 6, respectively. Conclusions: Total continence was achieved even after a brief folowup in a minority of patients in whom rectus fascia was used to correct neurogenic incontinence. However, our early data suggest that cases in which these procedures fail may be salvaged by artificial urinary sphincter implantation but not by periurethral collagen injection.
引用
收藏
页码:272 / 274
页数:3
相关论文
共 21 条
[1]   SUCCESS OF THE ARTIFICIAL URINARY SPHINCTER AFTER FAILED SURGERY FOR INCONTINENCE [J].
ALIABADI, H ;
GONZALEZ, R .
JOURNAL OF UROLOGY, 1990, 143 (05) :987-990
[2]   THE USE OF RECTUS FASCIA TO MANAGE URINARY-INCONTINENCE [J].
BAUER, SB ;
PETERS, CA ;
COLODNY, AH ;
MANDELL, J ;
RETIK, AB .
JOURNAL OF UROLOGY, 1989, 142 (02) :516-519
[3]   EXPERIENCE WITH THE KROPP ANTI-INCONTINENCE PROCEDURE [J].
BELMAN, AB ;
KAPLAN, GW .
JOURNAL OF UROLOGY, 1989, 141 (05) :1160-1162
[4]   USE OF THE FASCIAL SLING FOR NEUROGENIC INCONTINENCE - LESSONS LEARNED [J].
DECTER, RM .
JOURNAL OF UROLOGY, 1993, 150 (02) :683-686
[5]   PERIURETHRAL AND PUBOPROSTATIC SLING REPAIR FOR INCONTINENCE IN PATIENTS WITH MYELODYSPLASIA [J].
ELDER, JS .
JOURNAL OF UROLOGY, 1990, 144 (02) :434-437
[6]  
Elder JS, 1998, J UROLOGY, V159, P26
[7]  
Erhard MJ, 1997, PEDIATRICS, V100, P558
[8]   LONG-TERM RESULTS OF THE ARTIFICIAL URINARY SPHINCTER IN MALE-PATIENTS WITH NEUROGENIC BLADDER [J].
GONZALEZ, R ;
MERINO, FG ;
VAUGHN, M .
JOURNAL OF UROLOGY, 1995, 154 (02) :769-770
[9]   PUBOVAGINAL SLINGS FOR THE MANAGEMENT OF URINARY-INCONTINENCE IN FEMALE ADOLESCENTS [J].
GORMLEY, EA ;
BLOOM, DA ;
MCGUIRE, EJ ;
RITCHEY, ML .
JOURNAL OF UROLOGY, 1994, 152 (02) :822-825
[10]   URETHRAL LENGTHENING AND REIMPLANTATION FOR NEUROGENIC INCONTINENCE IN CHILDREN [J].
KROPP, KA ;
ANGWAFO, FF .
JOURNAL OF UROLOGY, 1986, 135 (03) :533-536