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Bladder Neck Injection of a Polydimethylsiloxane-Bulking Agent Under Pneumovesicum for Treatment of Children with Urinary Incontinence: Report of 3 Cases

Authors
 Dong Hoon Lee ; Cheol Young Oh ; Chang Hee Hong ; Ho Sung Jang 
Citation
 Journal of Laparoendoscopic & Advanced Surgical Techniques, Vol.23(3) : 297~300, 2013 
Journal Title
 Journal of Laparoendoscopic & Advanced Surgical Techniques 
ISSN
 1092-6429 
Issue Date
2013
Abstract
Introduction: To present the surgical technique and initial outcomes of bladder neck injection (BNI) of bulking agent under CO2-induced pneumovesicum to better visualize the bladder neck. Subjects and Methods: Three children (one 12 year old and two 14 year olds) who underwent polydimethylsiloxane BNI under pneumovesicum for treatment of bladder neck incompetence were retrospectively reviewed. Patient diagnoses included an imperforate anus, joint hypermobility syndrome, and an ectopic ureter, respectively. BNI was performed with an antegrade approach under 10 mm Hg CO2 pneumovesicum after insertion of a 5-mm diameter trocar in the bladder dome. A single injection was given in all cases. Results: BNI was successfully completed in all patients. Bleeding that developed during bladder access or injection did not interrupt accurate positioning of the needle or confirmation of mucosal coaptation in the bladder neck. At 6 months postoperatively, all patients reported social continence, defined as minimal incontinence requiring no more than one pad daily. No intraoperative morbidity or postoperative deterioration of the upper urinary tract due to technique was observed. Conclusions: Antegrade BNI under pneumovesicum affords better visualization of the bladder neck, resulting in more accurate needle placement and better mucosal coaptation confirmation. Studies of larger patient samples are necessary to better study the efficacy of BNI with the patient under pneumovesicum.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/86674
DOI
10.1089/lap.2012.0240
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Urology
Yonsei Authors
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Link
 http://online.liebertpub.com/doi/abs/10.1089/lap.2012.0240
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