The Importance of Catheter Size in the Achievement of Urinary Continence in Patients Undergoing a Young-Dees-Leadbetter Procedure

Abstract

During the last 8 years 49 patients have undergone urinary tract reconstruction at our institution to manage urinary incontinence. Of these patients 25 underwent a Young-Dees-Leadbetter procedure, of whom 13 boys and 6 girls were available for followup. Average patient age was 12.2 years and mean followup is 30.2 months. Augmentation cystoplasty was required in 14 cases. All 12 patients (100%) undergoing tubularization over an 8F catheter attained diurnal continence, and 92% are completely continent day and night. Furthermore, the 6 patients in whom augment capacities attained were less than the expected volume for age were also completely continent when tubularization was performed over an 8F catheter. We conclude that creation of a narrow (8F) Young-Dees-Leadbetter bladder neck tubularization leads to an increased likelihood of diurnal and nocturnal continence but precludes spontaneous unaided voiding to completion. Furthermore, achievement of urinary continence appears to be less dependent on bladder capacity when it is coupled with a narrow Young-Dees-Leadbetter tubularization.