title: [Use of polydimethylsiloxane in the endoscopic treatment of urinary incontinence of neurologic origin in children].
abstract: OBJECTIVE
  We report the use of polydimethylsiloxane (PDS-Macroplastique) in endoscopic treatment of urinary incontinence in children with neurogenic bladder and try to determine optimal criteria for patient selection.
  
  
  METHODS
  Forty four children (19 males, 25 females) have been treated since 1995. Aetiology was mainly spina bifida (n = 36). Previous surgery had been performed in 26 patients, including bladder neck reconstruction in 21 cases and bladder augmentation in 15 cases. Mean age at injection was 13 years (7 to 17). Only one injection was performed in 27 patients, two injections in 4 cases, and three and more injections in 3 cases. Mean volume at each injection was 3.6 cc. Mean interval between two injections was 6 months (3-15 m). All injections were performed transurethrally.
  
  
  RESULTS
  Follow-up ranged from 6 to 41 months (median: 23). Fifteen patients (34%) are dry (continence > 4 hours, no urinary pad during the day) and 11 (25%) are improved (continence from 2 to 3 hours, minimal pad). Eighteen patients obtained poor results. In the entire series previous bladder neck surgery or preoperative detrusor hyperactivity did not interfere with the results. The only difference concerns the sex-ratio: the good results were mainly seen in females: 44% of girls are cured versus 21% of boys.
  
  
  CONCLUSIONS
  Injection of PDS in the bladder neck achieve the goal of continence in 34% of the cases in neurogenic bladder. Better results are seen in girls. Injection does not compromise other surgical procedures. The use of PDS seems more suitable than bovine collagen in view of the potential problems of prions.
authors.affiliation: Département de Chirurgie Pédiatrique, Hôpital d'Enfants de la Timone, Marseille.
authors.forename: J M
authors.initials: JM
authors.lastname: Guys
authors.forename: C
authors.initials: C
authors.lastname: Louis-Borrione
authors.forename: D
authors.initials: D
authors.lastname: Battagliola
authors.forename: H
authors.initials: H
authors.lastname: Le Hors-Albouze
authors.forename: P
authors.initials: P
authors.lastname: Petit
mesh_terms: D000293:Adolescent; D000818:Animals; D002417:Cattle; D002648:Child; D003094:Collagen / Q000627:therapeutic use; D003558:Cystoscopy / Q000379:methods*; D004129:Dimethylpolysiloxanes / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections / Q000379:methods*; D008297:Male; D012737:Sex Factors; D012828:Silicones / Q000627:therapeutic use*; D016135:Spinal Dysraphism / Q000150:complications*; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000150:complications*; D014549:Urinary Incontinence / Q000188:drug therapy* / Q000209:etiology*; D014906:Wetting Agents / Q000627:therapeutic use*
chemical_list: D004129:Dimethylpolysiloxanes; D012828:Silicones; D014906:Wetting Agents; C013830:baysilon; D003094:Collagen