title: The Pippi Salle urethral lengthening procedure; experience and outcome from three United Kingdom centres.
abstract: 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.
authors.affiliation: Department of Paediatric Urology, Southampton General Hospital, London, UK.
authors.forename: M C
authors.initials: MC
authors.lastname: Hayes
authors.forename: A
authors.initials: A
authors.lastname: Bulusu
authors.forename: T
authors.initials: T
authors.lastname: Terry
authors.forename: P D
authors.initials: PD
authors.lastname: Mouriquand
authors.forename: P S
authors.initials: PS
authors.lastname: Malone
mesh_terms: 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*