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Aim: A three-year retrospective study was performed to assess the place of the Pippi Salle bladder neck repair in the treatment of neurogenic bladder incontinence in both sexes in childhood.
Method: All children who underwent the procedure between November 1995 and November 1998 were studied retrospectively. There were 18 children: 12 with spina bifida, 5 with sacral agenesis and 1 with an idiopathic neurogenic bladder. There were 11 boys and 7 girls. Their age was 3-14 years (median 7 years) and the length of follow-up was 7 months to 3 years (median 2 years). A midline bladder wall flap was fashioned in all patients. The procedure was performed alone (n = 5) or in combination with a sigmoid colocystoplasty (n = 9) or a Mitrofanoff catheterisable stoma (n = 2) or both (n = 2).
Results: Diurnal continence (3 hours or more) was achieved in 11 of the 18 children (61%); 2 are dry for 2-2.5 hours and 5 are incontinent. Eight of the 18 children (44%) are completely dry during the night, 2 are damp and 8 are incontinent. Twelve children (67%) needed oxybutynin to maintain a good result. Complications arose in 5 children (28%): difficulty with catheterisation (n = 4) and pelvic abscess (n = 1). Seven children (39%) subsequently required further operations: exploration of bladder for urine leak (n = 2), reinsertion of dislodged catheter (n = 1), drainage of pelvic abscess (n = 1), bladder neck injection with macroplastique (n = 1) and bladder neck closure (n = 2).
Conclusions: The Pippi Salle bladder neck repair has an undoubted place in the management of neurogenic urinary incontinence in childhood. However, in our experience, it has a relatively high complication rate and failure rate.
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http://dx.doi.org/10.1055/s-2008-1072303 | DOI Listing |
Exp Ther Med
February 2025
Department of Urology, Konstantopouleio-Patision General Hospital of Nea Ionia, 14233 Nea Ionia, Greece.
A 79-year old Caucasian male with metastatic hormone refractory prostate cancer and bilateral nephrostomy was admitted to the emergency department due to 4-day bloody urethral discharge, weakness and dizziness. The patient was treated with the luteinizing hormone-releasing hormone-antagonist and abiraterone acetate plus prednisone, dabigatran 150 mg bid (for atrial fibrillation and coronary heart disease) and 5-aminosalicylic acid for the management of mild ulcerative colitis. Imaging revealed bladder overdistention and blood analysis low levels of hematocrit (HCT) and hemoglobin (HGB) (HCT, 22%; HGB, 7.
View Article and Find Full Text PDFUrologia
December 2024
Department of Medicine and Translational Surgery, Università Cattolica del Sacro Cuore, Rome, Italy.
Introduction: Robot-assisted radical prostatectomy (RARP) is the treatment option for localized prostate cancer. It can lead to side effects like erectile dysfunction (ED) and post-prostatectomy urinary incontinence (PPUI). This study aimed to evaluate association between dyadic adjustment, PPUI and ED.
View Article and Find Full Text PDFFr J Urol
December 2024
Centres médicaux-chirurgicaux Ambroise Paré, Hartmann, Pierre Cherest, 26 Bd Victor Hugo, 92200 Neuilly-sur-Seine, France.
Introduction: Numerous anatomical theories have been developed to explain women stress urinary incontinence (SUI) and improve its management. The transperineal ultrasound is an efficient and non-invasive exam that perfectly studies the bladder neck movement and the urethral anatomy. The measurement of the static portion of the distal urethral length, considered as the functional urethral length (FUL), and of the posterior urethral closure angle (PUCA) have not been studied before and could be of interest.
View Article and Find Full Text PDFInt Urogynecol J
December 2024
Department of Ultrasound, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, Guangdong, China.
Introduction And Hypothesis: This study examines the effectiveness of yoga intervention on the early postpartum recovery of pelvic organ positions.
Methods: A prospective study was conducted from May to November 2020, involving women who had vaginal deliveries and underwent pelvic floor ultrasound examinations. The control group received no intervention, whereas the experimental group participated in weekly 60-min yoga sessions from 1 week to 3 months postpartum.
JCEM Case Rep
January 2025
Division of Endocrinology, Medstar Georgetown University Hospital, Washington, DC 20007, USA.
Patients with intermediate-risk thyroid cancers may undergo treatment with radioactive iodine-131 (I-131). They often undergo a pretreatment diagnostic iodine scan that typically shows areas of physiological uptake in the stomach, bladder, parotid glands as well as thyroid-remnant uptake and sites of metastatic disease. A 48-year-old woman with intermediate-risk papillary thyroid cancer with metastases to lateral compartment lymph nodes was found to have increased retention of iodine in the medial portion of her left orbit on the diagnostic scan.
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