title: Closure of the bladder neck in spinal cord injury patients with urethral sphincteric incompetence and irreparable urethral pathological conditions.
abstract: Total urinary incontinence developed secondary to incompetence of the urethral closing mechanism in 8 spinal cord injury patients who were on Foley catheter drainage (5 patients) or suprapubic cystostomy (3 patients). All patients had irreparable urethrocutaneous fistulas and 4 had urethroperineal erosion. Closure of the bladder neck with drainage via a suprapubic cystostomy tube was used to divert the urinary stream. Bladder neck closure was successful in alleviating total urethral urinary incontinence in all patients. However, suprapubic abdominal leakage developed in 2 patients. This procedure should be recommended cautiously when a maximal bladder capacity greater than 125 cc cannot be maintained unless concomitant augmentation cystoplasty also is considered.
mesh_terms: D006801:Humans; D013119:Spinal Cord Injuries / Q000150:complications; D014522:Urethral Diseases / Q000209:etiology / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*; D014549:Urinary Incontinence / Q000209:etiology / Q000601:surgery*