title: Initial experience with the transurethral self-detachable balloon system for urinary incontinence in pediatric patients.
abstract: OBJECTIVE
  A new endoscopic technique to treat urinary incontinence in children using a self-detachable balloon device was studied.
  
  
  METHODS
  The study includes 11 patients with a mean age of 14.6 years and all of whom had intrinsic sphincter deficiency due to myelomeningocele in 9, spinal artery bleed in 1 and cloacal exstrophy in 1. All patients were on clean intermittent catheterization preoperatively and postoperatively. Endoscopic balloon treatment was performed on an outpatient basis. A mean of 5 balloons (range 2 to 8) were placed per patient. All patients underwent formal urodynamic study preoperatively and at 6 weeks and 6 months following balloon placement.
  
  
  RESULTS
  Of the 9 patients without prior bladder neck surgery 7 had improvement in urodynamic parameters, including urethral pressure profile in all 7 and functional bladder capacity in 6, 4 were markedly improved clinically and 2 were dry. Two patients with prior bladder neck surgery were clinically unchanged following balloon placement, although 1 had urodynamic improvement.
  
  
  CONCLUSIONS
  Our initial experience with the transurethral self-detachable balloon system as a minimally invasive outpatient procedure to treat urinary incontinence in children has been encouraging. To date this procedure appears most applicable to the patient who has not undergone surgery and has a neurogenic etiology for urinary incontinence.
authors.affiliation: Department of Urology, Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Diamond
authors.forename: S B
authors.initials: SB
authors.lastname: Bauer
authors.forename: A B
authors.initials: AB
authors.lastname: Retik
authors.forename: A
authors.initials: A
authors.lastname: Atala
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000601:surgery*; D014563:Urodynamics