Journal of Shandong University (Health Sciences) ›› 2019, Vol. 57 ›› Issue (11): 42-46.doi: 10.6040/j.issn.1671-7554.0.2019.759

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Bladder neck suspension with pyramidalis in the management of pediatric urinary incontinence

MA Nan, WANG Ruoyi, LIU Qian, LUO Juan, LI Jinliang, CHEN Weixiu   

  1. Department of Pediatric Surgery, The Second Hospital of Shandong University, Jinan 250033, Shandong, China
  • Published:2022-09-27

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Abstract: Objective To evaluate the clinical efficacy of bladder neck suspension with pyramidalis in the treatment of urinary incontinence in children with sphincteric incompetence. Methods Clinical data of 29 children with urinary incontinence who underwent bladder neck suspension with pyramidalis during 2004 and 2018 were retrospectively analyzed. All patients received urodynamic examinations and voiding cystourethrography(VCUG), and filled in ICI-Q-SF scale before and after operation. The differences in the indexes were analyzed with paired samples t test and Wilcoxon rank sum test. Results VCUG showed the bladder necks were raised in all patients and the funnel-shaped openings were corrected. The functional urethral length and maximum urethral closure pressure increased by 1.04 cm(P<0.001)and 11.69 cmH2O(P=0.001), respectively, while the maximum urethral pressure had no improvement after surgery(P>0.05). The ICI-Q-SF score showed that incontinence was significantly improved(P<0.05), 11 patients(37.93%)gained good control with adjuvant clean intermittent catheterization(CIC)and oral anticholinergic drugs, and the other 18 patients showed CIC problems. Complications were observed in 7 patients(24.14%), and 2 patients(6.90%)complications were caused by bladder neck suspension. Conclusion Bladder neck suspension with pyramidalis is effective to treat children with sphincteric incompetence if standardized CIC and anticholinergic medication are provided.

Key words: Pyramidalis, Urinary incontinence, Bladder neck suspension, Urethral sphincter, Bladder outlet resistance, Functional urethral length, Maximum urethral closure pressure

CLC Number: 

  • R726.9
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