Endoscopic Treatment of Urinary Incontinence: Long-Term Evaluation of the Results

Guys, Jean-Michel; Fakhro, Abdulla; Louis-Borrione, C.; Prost, J F; HAUTIER, A.

doi:10.1097/00005392-200106001-00043

Cited by 9 publications

(11 citation statements)

References 19 publications

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“…We confirm, like Guys et al [14], that Macroplastique causes no allergic reaction, and similar to previous reported series [14,16,17], submucosal injection with bulking agent is easy in children, with minimal morbidity and in an outpatient setting. As reported by others [18,19] we encountered no deterioration of the upper tracts due to any increase in the voiding pressure.…”

Section: Discussionsupporting

confidence: 93%

“…In the present series, a history of previous BNR did not improve the chances of a better outcome with Macroplastique injection; this is in agreement with Guys et al [14]. Although others have reported that the results are better in patients with Young-Dees BNR [16], patients with EEC fare better than those with neurogenic bladders [16,20,21].…”

Section: Discussionsupporting

confidence: 92%

“…Although others have reported that the results are better in patients with Young-Dees BNR [16], patients with EEC fare better than those with neurogenic bladders [16,20,21]. Also, a failed Macroplastique injection did not affect the technical aspects of later surgical procedures; this is in agreement with reports of other investigators [14,17].…”

Section: Discussionsupporting

confidence: 88%

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Injectable polydimethylsiloxane for treating incontinence in children with the exstrophy‐epispadias complex: long‐term results

et al. 2006

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In this section authors from the UK describe their experience with plastic injections for treating incontinence in children with the exstrophy‐epispadias complex, finding that in the long term the success rate was reasonable, although the injections often needed to be repeated. Authors from Brazil present an analysis of anomalies of the epididymis and processus vaginalis in human fetuses, and in patients with cryptorchidism treated and untreated with hCG. OBJECTIVE To present our experience with the use of injectable polydimethylsiloxane (MacroplastiqueTM, Uroplasty, Minneapolis, MI, USA) for treating incontinence in children with the exstrophy‐epispadias complex (EEC), as incontinence continues to be a challenging problem in such children, and although the primary management of EEC has developed over the last few decades, with early closure and reconstruction of the penis, achieving satisfactory continence status remains elusive. PATIENTS AND METHODS We retrospectively reviewed the hospital records of 52 patients (41 boys and 11 girls, mean age at first injection 6.6 years, range 3.6–16.7) with EEC who had injections with Macroplastique between January 1991 and February 2004; 34 had bladder exstrophy and 18 primary epispadias. For this study we defined success as complete dryness with no use of pads or nappies. Improvement was defined as being occasionally wet but with dry intervals lasting ≥ 4 h. RESULTS The mean (range) follow‐up was 4.6 (0.5–9) years. Twenty patients had one injection, 10 had two, 13 had three, six had four, two had six and one had seven injections. In most patients a maximum of three injections predicted the outcome. The injection of Macroplastique was successful in nine patients (17%; with an annual follow‐up, two at 1–2 years, three at 2–5 years and four at >5 years), whilst 17 (33%) improved significantly (one at <1 year, two at 1–2 years, eight at 2–5 years and six at >5 years). Those patients comprised five of 18 (27%) with epispadias and four of 34 (12%) with exstrophy. A history of previous surgery and gender had no significant effect on the outcome. Overall half the patients benefited from the procedure. CONCLUSIONS This series confirms that injection with Macroplastique is minimally invasive, durable in significantly many patients and has a reasonable success rate. A history of previous surgery and gender had no significant effect on the outcome. Patients with epispadias are more likely to benefit from an injection with Macroplastique than those with bladder exstrophy. A maximum of three injections is predictive with reasonable certainty of any benefit from the procedure.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 88%

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Injectable polydimethylsiloxane for treating incontinence in children with the exstrophy‐epispadias complex: long‐term results

et al. 2006

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“…Positive aspects in favour of bulking agents are lower costs, shorter hospitalization, and less trauma in the patient than major continence surgical procedures [34]. Interestingly, Guys et al reported the results of a similar prospective study in 46 children with major structural incontinence related to neuropathic bladder dysfunction that was treated with endoscopic polydimethylsiloxane injections [35]. On the other hand, Dyer et al in their series of 34 patients who underwent primary injection of bulking agents did not find a significant improvement in continence, concluding that is often ineffective and expensive [36].…”

Section: Discussionmentioning

confidence: 99%

Severe Hydronephrosis and Dysuria-Hematuria Syndrome after 20 Years of Bladder Exstrophy Correction: A Case Report

Altobelli

Bove

Sergi

et al. 2012

Case Reports in Urology

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“…[2–6] Other methods like placement of artificial or autologous bulking agent have also been described creating a fixed bladder outlet resistance. [7] Recently, creation of innervation preserving composite outlet resistance similar to the mechanism provided by the nature comprising of smooth as well as striated muscle reconstruction as one unit has been described by us. [8]…”

Section: Introductionmentioning

confidence: 99%

Bladder exstrophy: Comparison of anatomical bladder neck repair with innervation preserving sphincteroplasty versus Young-Dees-Leadbetter bladder neck reconstruction

Gupta

Kureel

Wakhlu

et al. 2013

J Indian Assoc Pediatr Surg

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Aim:To evaluate the outcome of innervation preserving sphincteroplasty along with anatomical bladder neck reconstruction (IPS-ABNR) compared to classic Young-Dees-Leadbetter (YDL) bladder neck reconstruction in exstrophy with insufficient bladder capacity requiring detubularized-ileocystoplasty.Materials and Methods:Sixteen male patients of exstrophy bladder who required ileocystoplasty from 2004 to 2010 were randomized into group A (n = 7) and group B (n = 9). After detubularized-ileocystoplasty with Mitrofanoff stoma and ureteric reimplantation in all, group A received YDL bladder neck repair while group B received IPS-ABNR repair through a midline scrotoperineal approach. Outcome measurement included operative and postoperative problems, continence, and upper tract status.Results:In group A, two had incompetent bladder neck with gross incontinence, while four had a dry interval of more than 3 h without the ability of voiding per urethra. In group B, seven patients had dry interval of more than 3 h with an ability of urethral voiding and midstream holding in five.Conclusions:Exstrophy patients requiring augmentation cystoplasty and repaired with IPS-ABNR can achieve dynamic bladder outlet resistance with adequate leak point pressure and ability to void voluntarily with midstream holding capability. The children had the satisfaction of voiding per urethra with ability to stop in midstream similar to that in normal children.

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Endoscopic Treatment of Urinary Incontinence: Long-Term Evaluation of the Results

Cited by 9 publications

References 19 publications

Injectable polydimethylsiloxane for treating incontinence in children with the exstrophy‐epispadias complex: long‐term results

Injectable polydimethylsiloxane for treating incontinence in children with the exstrophy‐epispadias complex: long‐term results

Severe Hydronephrosis and Dysuria-Hematuria Syndrome after 20 Years of Bladder Exstrophy Correction: A Case Report

Bladder exstrophy: Comparison of anatomical bladder neck repair with innervation preserving sphincteroplasty versus Young-Dees-Leadbetter bladder neck reconstruction

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