title: Intraoperative urethral pressure profilometry as an adjunct to bladder neck reconstruction.
abstract: Between 1975 and 1984 we performed 17 bladder neck reconstructions with bladder neck suspension using intraoperative urethral pressure profilometry. Studies were done intraoperatively after bladder neck reconstruction and then they were repeated after bladder neck suspension. A continence length of 25 to 35 mm. and a urethral closure pressure of greater than 60 cm. water were obtained in all patients. Bladder neck suspension was noted to increase the continence length in all patients and allowed for at least a 2-fold increase in the closure pressures that were obtained. Urinary continence was assessed postoperatively from parental interviews. It seems important to achieve an initial closure pressure of at least 60 cm. water, while at the same time attempting to ensure anterior fixation. Intraoperative urethral pressure profilometry can serve as a valuable adjunct to bladder neck reconstruction by confirming the adequacy of bladder neck resistance after bladder neck reconstruction and again after bladder neck suspension.
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D011312:Pressure; D014521:Urethra / Q000502:physiology*; D001743:Urinary Bladder / Q000601:surgery*; D014549:Urinary Incontinence / Q000601:surgery*