Urinary Incontinence
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Studies from Children's Memorial Hospital, Division of Urology have provided new data on incontinence
2009 JUL 27 - (NewsRx.com) -- New investigation results, 'Bulbar urethral ligation for managing persistent urinary incontinence in young men with myelomeningocele,' are detailed in a study published in Bju International. "To report our experience with ligation of the bulbar urethra for treating refractory stress incontinence in a selected group of young men with neuropathic bladders secondary to myelomeningocele (MM), in whom primary anti-incontinence procedures had failed. Persistent urethral incontinence leading to chronic perineal skin ulceration can occur in these patients, despite aggressive medical and surgical efforts to decrease wetting by increasing bladder capacity, compliance and outlet resistance," researchers in the United States report. "Four young men with MM had bulbar urethral ligation; all had undergone a previous ileocystoplasty and functioning continent catheterizable channels (CCC, three appendicovesicostomies, one Monti procedure). Three patients had primary bladder neck procedures using rectus fascia slings, and secondary attempts were made at urethral bulking in two patients. All patients had persistent incontinence through their native urethra, with dry intervals of <2 h. The bulbar urethra was ligated through a small midline perineal incision at 1 year after augmentation, and successfully resolved incontinence in all four patients. All reported satisfaction with their bladder regimen at a mean (range) follow-up of 49 (20-93) months. There were no perineal wound infections. While one patient developed bladder calculi, no patient developed urethral stones, febrile urinary tract infections, fistulae or bladder perforations. We report the results of bulbar urethral ligation for resolution of incontinence in patients with MM in whom anti-incontinence bladder neck procedures had failed," wrote J.J. Meeks and colleagues, Children's Memorial Hospital, Division of Urology. The researchers concluded: "Ligation of the urethra is effective, and can be considered an alternative treatment for refractory urinary incontinence in patients with a functional CCC in whom previous bladder neck-supporting procedures have failed." Meeks and colleagues published their study in Bju International (Bulbar urethral ligation for managing persistent urinary incontinence in young men with myelomeningocele. Bju International, 2009;104(2):221-4). For additional information, contact J.J. Meeks, Children's Memorial Hospital, Division of Urology, Chicago, IL 60614 USA.. Publisher contact information for the journal Bju International is: Blackwell Publishing Inc., 350 Main St., Malden, MA 02148, USA. Keywords: United States, Chicago, Incontinence, Urinary Incontinence, Urology. This article was prepared by Gastroenterology Week editors from staff and other reports. Copyright 2009, Gastroenterology Week via NewsRx.com.
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