The Pippi Salle urethral lengthening procedure; experience and outcome from three United Kingdom centres.
OBJECTIVE
To assess the outcome of the Pippi Salle (Kropp onlay) urethral lengthening procedure in the treatment of neuropathic urinary incontinence.


METHODS
Twenty-eight patients (12 males and 16 females, mean age at surgery 12.6 years, range 7-32) were identified who underwent the procedure between 1993 and 1997 in the United Kingdom. Outcomes were assessed by a review of the case notes.


RESULTS
Of the 28 patients, 18 (64%) were rendered continent by day, and 17 (61%) by day and night. Twelve of the 16 females were completely dry, and a further girl was dry by day, giving overall daytime continence in 13 patients; five males were rendered continent (P=0.03, chi-square test). Four patients required revision surgery; in five patients (two females and three males) the method was abandoned and they underwent an alternative procedure, and a further four are being reassessed.


CONCLUSIONS
The Pippi Salle procedure should be considered as a first-line treatment option for neuropathic incontinence in females. Its place in the management of incontinent males is less convincing.
Hayes
M C
MC
Department of Paediatric Urology, Southampton General Hospital, London, UK.
Bulusu
A
A
Terry
T
T
Mouriquand
P D
PD
Malone
P S
PS
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016896:Treatment Outcome; D006113:United Kingdom; D014521:Urethra / Q000601:surgery*; D001750:Urinary Bladder, Neurogenic / Q000150:complications; D014549:Urinary Incontinence / Q000209:etiology / Q000601:surgery*