CONCOMITANT MODIFIED BLADDER NECK CLOSURE AND MITROFANOFF URINARY DIVERSION

Abstract

We describe a modification of bladder neck closure for managing urinary incontinence in children. In 11 patients with intractable urinary incontinence that persisted after multiple failed surgical procedures we performed modified bladder neck closure with construction of a catheterizable continent conduit. Mean followup is 3 years. All patients were continent after the procedure and none had a fistula or urinary leakage. One patient required stomal and conduit revision, and bladder stones in 3 necessitated endoscopic removal. We recommend this modified technique of bladder neck closure as an option for managing urinary incontinence in a complex group of children because it allows the achievement of continence with minimal morbidity.