Failed bladder neck reconstruction: Options for management

John Phillip Gearhart, D. A. Canning, R. D. Jeffs

Research output: Contribution to journalArticle

Abstract

During the last 10 years 17 patients have been seen at this institution for persistent urinary incontinence after Young-Dees-Leadbetter bladder neck reconstruction. Of these patients 16 were born with classical bladder exstrophy and 1 with complete epispadias. Six patients underwent 1, 10 underwent 2 and 1 underwent 3 prior bladder neck procedures. As salvage procedures 8 patients underwent another Young-Dees-Leadbetter procedure, 1 repeat bladder neck reconstruction and augmentation cystoplasty, 3 augmentation alone, 4 bladder augmentation with creation of a continent abdominal stoma and 1 augmentation with implantation of an artificial urinary sphincter. Of the 8 patients who underwent a repeat Young-Dees-Leadbetter procedure 7 are dry for 3 hours or more and 1 is dry for greater than 3 hours on intermittent self-catheterization. All of those who are dry for greater than 3 hours are dry at night and 1 wears pads when engaging in strenuous physical activity. Of the 9 patients who underwent augmentation cystoplasty along with other adjunctive procedures 8 are continent for greater than 3 hours on intermittent catheterization, 6 are dry at night if they perform catheterization at bedtime and 1 remains totally incontinent after removal of the artificial urinary sphincter. Thus, with persistence and creativity a child with a previously failed bladder neck reconstruction or even multiple failed repairs can be made socially continent, providing a satisfactory alternative without resorting to urinary diversion.

Original languageEnglish (US)
Pages (from-to)1082-1084
Number of pages3
JournalJournal of Urology
Volume146
Issue number4
StatePublished - 1991

Fingerprint

Urinary Bladder
Artificial Urinary Sphincter
Catheterization
Epispadias
Bladder Exstrophy
Urinary Diversion
Creativity
Urinary Incontinence
Exercise

Keywords

  • Bladder exstrophy
  • Bladder neck obstruction
  • Urinary incontinence

ASJC Scopus subject areas

  • Urology

Cite this

Gearhart, J. P., Canning, D. A., & Jeffs, R. D. (1991). Failed bladder neck reconstruction: Options for management. Journal of Urology, 146(4), 1082-1084.

Failed bladder neck reconstruction : Options for management. / Gearhart, John Phillip; Canning, D. A.; Jeffs, R. D.

In: Journal of Urology, Vol. 146, No. 4, 1991, p. 1082-1084.

Research output: Contribution to journalArticle

Gearhart, JP, Canning, DA & Jeffs, RD 1991, 'Failed bladder neck reconstruction: Options for management', Journal of Urology, vol. 146, no. 4, pp. 1082-1084.
Gearhart, John Phillip ; Canning, D. A. ; Jeffs, R. D. / Failed bladder neck reconstruction : Options for management. In: Journal of Urology. 1991 ; Vol. 146, No. 4. pp. 1082-1084.
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