Ces Urol 1999, 3(3):30-34

Surgery of bladder neck in children and adolescents

K. Novák¹, R. Kočvara^1,3, Z. Dítě^1,3, J. Dvořáček^1,2, J. Kříž¹

¹ Urologická klinika VFN a 1. LF UK, Praha,

² Katedra urologie IPVZ, Praha

³ Subkatedra dětské urologie IPVZ, Praha

Bladder neck surgery represents an important part of the incontinence treatment in children and adolescents. Purpose of the retrospective study was to evaluate 30 patients after the bladder neck repair. They underwent operation between 1986 and 1998 (13 boys and 17 girls). The bladder neck was repaired in 27 patients, closed in 3. Bladder augmentation was indicated in 15 patients, ureterovesicostomy in 12 with vesi-coureteral reflux. Follow-up of 27 patients was performed (15 with augmentation and 12 without augmentation).
Six (40 %) children in the group with augmentation are continent, 6 (40 %) significantly improved and 3 (20 %) remain incontinent. Five (42 %) patients in the non-augmented group are continent and 7 (58 %) are significantly improved. All patients in augmented group perform clean intermittent catheterization. No deterioration of renal function was encountered. Vesicoureteral reflux persists in 5 from 12 patients after ureterovesicostomy.
We improved incontinence by surgical procedures in 90 % children and adolescents with neurogenic bladder or extrophy/epispadias complex.

Keywords: Urinary incontinence in children and adolescents, Bladder neck surgery, Neurogenic bladder, Exstrophy/epispadias complex

Published: June 1, 1999