INITIAL EXPERIENCE WITH THE TRANSURETHRAL SELF-DETACHABLE BALLOON SYSTEM FOR URINARY INCONTINENCE IN PEDIATRIC PATIENTS

Abstract

No AccessJournal of UrologyReconstruction1 Sep 2000INITIAL EXPERIENCE WITH THE TRANSURETHRAL SELF-DETACHABLE BALLOON SYSTEM FOR URINARY INCONTINENCE IN PEDIATRIC PATIENTS DAVID A. DIAMOND, STUART B. BAUER, ALAN B. RETIK, and ANTHONY ATALA DAVID A. DIAMONDDAVID A. DIAMOND More articles by this author , STUART B. BAUERSTUART B. BAUER More articles by this author , ALAN B. RETIKALAN B. RETIK More articles by this author , and ANTHONY ATALAANTHONY ATALA More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)67222-9AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: A new endoscopic technique to treat urinary incontinence in children using a self-detachable balloon device was studied. Materials and Methods: The study includes 11 patients with a mean age of 14.6 years and all of whom had intrinsic sphincter deficiency due to myelomeningocele in 9, spinal artery bleed in 1 and cloacal exstrophy in 1. All patients were on clean intermittent catheterization preoperatively and postoperatively. Endoscopic balloon treatment was performed on an outpatient basis. A mean of 5 balloons (range 2 to 8) were placed per patient. All patients underwent formal urodynamic study preoperatively and at 6 weeks and 6 months following balloon placement. Results: Of the 9 patients without prior bladder neck surgery 7 had improvement in urodynamic parameters, including urethral pressure profile in all 7 and functional bladder capacity in 6, 4 were markedly improved clinically and 2 were dry. Two patients with prior bladder neck surgery were clinically unchanged following balloon placement, although 1 had urodynamic improvement. Conclusions: Our initial experience with the transurethral self-detachable balloon system as a minimally invasive outpatient procedure to treat urinary incontinence in children has been encouraging. To date this procedure appears most applicable to the patient who has not undergone surgery and has a neurogenic etiology for urinary incontinence. References 1 : Exstrophy-epispadias complex in bladder anomalies. In: . Philadelphia: Saunders1998. Google Scholar 2 : Urethral lengthening with anterior bladder wall flap for urinary incontinence: a new approach. J Urol1994; 152: 803. Google Scholar 3 : Management of urinary incontinence by bladder tube urethral lengthening and submucosal implantation. J Urol1990; 144: 559. Link, Google Scholar 4 : Experience with the Kropp anti-incontinence procedure. J Urol1989; 141: 1160. Link, Google Scholar 5 : Use of the AS800 device in exstrophy and epispadias. J Urol1988; 140: 1202. Link, Google Scholar 6 : Detachable self-sealing membrane system for the endoscopic treatment of incontinence. J Urol1997; 158: 1045. Link, Google Scholar 7 : The long-term results of artificial sphincters in children. J Urol1991; 146: 396. Link, Google Scholar 8 : Polytetrafluoroethylene injection for urinary incontinence in children. J Urol1985; 133: 248. Link, Google Scholar 9 : Glutaraldehyde cross-linked bovine collagen in exstrophy/epispadias complex. J Urol1993; 150: 631. Link, Google Scholar 10 : Endoscopic treatment of vesico-ureteric reflux and urinary incontinence: technical problems in the paediatric patient. Br J Urol1995; 75: 538. Google Scholar 11 : Treatment of urinary incontinence in children by endoscopically directed bladder neck injection of collagen. J Urol1996; 156: 637. Link, Google Scholar 12 : Endoscopic treatment for urinary incontinence in children with a congenital neuropathic bladder. Br J Urol1998; 82: 694. Crossref, Medline, Google Scholar 13 : Failure to obtain durable results with collagen implantation in children with urinary incontinence. J Urol1997; 157: 2306. Link, Google Scholar 14 : Endoscopic treatment of urinary incontinence in children with primary epispadias. Br J Urol1998; 81: 309. Crossref, Medline, Google Scholar 15 : Migration and granulomatous reaction after periurethral injection of polytef (Teflon). JAMA1984; 251: 32. Google Scholar From the Department of Urology, Children’s Hospital, Harvard Medical School, Boston, Massachusetts© 2000 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 164Issue 3 Part 2September 2000Page: 942-946 Advertisement Copyright & Permissions© 2000 by American Urological Association, Inc.Keywordsurethrapediatricsurinary incontinenceendoscopyMetricsAuthor Information DAVID A. DIAMOND More articles by this author STUART B. BAUER More articles by this author ALAN B. RETIK More articles by this author ANTHONY ATALA More articles by this author Expand All Advertisement PDF downloadLoading ...