The results of 20 years of bladder neck surgery in children with neurogenic bladder or exstrophy/epispadias

Introduction: This is a retrospective study of bladder neck surgery performed in our hospital to gain insight into short and long term results on continence in children with complex incontinence problems. Material and methods: The records of 101 children were analyzed. In 59 children there was a urinary incontinence with neurogenic sphincteric incompetence versus 42 children with exstrophy or epispadias. Continence was defined as complete dryness for vier hours between voidings or catheterizations. Results: In the neurogenic group 25% was continent within one year after bladder neck surgery. Additionally 42% underwent a bladder neck repair, whereupon 66% achieved continence. In the non-neurogenic group 40% was continent within one year. In 45% additional bladder neck surgery was performed and subsequently 90% were continent (follow-up eight yrs). Conclusion: With the strict definition of continence the primary effect of bladder neck surgery is somewhat disappointing. However, with additional interventions the majority of patients can be consistently dry. Outcome is in favor of the nonneurogenic group.

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