745 DURABILITY OF CONTINENCE RATE ACHIEVED WITH DEXTRANOMER BASED IMPLANTS (DEFLUX®): A STUDY OF 89 PATIENTS

Abstract

You have accessJournal of UrologyPediatrics: Bladder Dysfunction - Myelodysplasia, Voiding Dysfunction, Enuresis1 Apr 2010745 DURABILITY OF CONTINENCE RATE ACHIEVED WITH DEXTRANOMER BASED IMPLANTS (DEFLUX®): A STUDY OF 89 PATIENTS Ilona Alova, Marc Margaryan, Michele Bernuy, Stephen Lortat Jacob, Yves Aigrain, and Henri Lottmann Ilona AlovaIlona Alova Paris, France More articles by this author , Marc MargaryanMarc Margaryan Paris, France More articles by this author , Michele BernuyMichele Bernuy Saint Fargeau, France More articles by this author , Stephen Lortat JacobStephen Lortat Jacob Paris, France More articles by this author , Yves AigrainYves Aigrain Paris, France More articles by this author , and Henri LottmannHenri Lottmann Paris, France More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1271AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES It has already been published that after an initial high success rate up to 70%, endoscopic treatment of severe paediatric structural incontinence allows to achieve dryness or acceptable social continence in about 50% of treated patients after 18 months. It has also been reported through relatively small series with limited follow up (FU) that this result remains stable thereafter. The current study evaluates the durability of Dextranomer based implants (DefluxÒ) as a bulking agent for paediatric structural incontinence. METHODS From October 1997, 86 children and adolescents (3-18years) suffering from severe sphincteric incompetence (exstrophy-epispadias 33, neuropathic bladder 44, bilateral ectopic ureters 5, miscellaneous 4) have been treated and followed for a minimum of 18months up to 12 years (median 60 months). A third had had a previous failed bladder neck procedure. Preoperative evaluation consisted in medical history and questionnaire about incontinence, urine culture, urinary tract ultrasound and videourodynamics. This evaluation was repeated at six months and one year after treatment and then on a yearly basis,except for videourodynamics performed only when necessary for further management. 25 patients had two and 13 three treatment sessions. Mean injected volume was 4,6 ml per session. At each evaluation, the patient was classified as cured (dryness interval of four hours ), significantly improved (minimal incontinence requiring no more than one pad per day; no further treatment required) and treatment failure when no significant improvement was observed. RESULTS 32 (37,2%) patient are dry, 13/86 (15,1%) are significantly improved, and 41/86 (47,7%) patients had treatment failure. After 18 months of FU 2 male patients became dry at puberty 2 Female patients became incontinent again. All the other patients remained perfectly stable. CONCLUSIONS Endoscopic treatment of urinary sphincter insufficiency with Deflux® is effective in around 50% of cases after 18months; our study with the largest reported cohort and the longest FU confirms that this result is durable up to 12 years thereafter. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e291-e292 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ilona Alova Paris, France More articles by this author Marc Margaryan Paris, France More articles by this author Michele Bernuy Saint Fargeau, France More articles by this author Stephen Lortat Jacob Paris, France More articles by this author Yves Aigrain Paris, France More articles by this author Henri Lottmann Paris, France More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...