title: Treatment of incontinence in children with bladder exstrophy after rectal urinary diversion: the anal sling procedure.
abstract: OBJECTIVE
  An original technique for reinforcement of the anal sphincter using a sling prosthesis with a flexible fixing point that prevents incontinence and rectal prolapse is presented.
  
  
  METHODS
  Of 43 patients with exstrophy who have undergone urinary rectal diversion between 1988 and 1997 incontinence was observed in 9 boys and 5 girls. From January 1993 to December 1998 these children were treated with an original method, the anal sling procedure.
  
  
  RESULTS
  There were no postoperative complications. Investigations revealed no urinary or fecal incontinence after a mean followup of 3.2 years (range 6 months to 61/2 years).
  
  
  CONCLUSIONS
  A short and simple operation eliminates incontinence after rectal urinary diversion in patients with bladder exstrophy. It can be used as an alternative to the formation of an isolated urinary reservoir.
authors.affiliation: Department of Pediatric Surgery, Russian State Medical University, Moscow, Russia.
authors.forename: V V
authors.initials: VV
authors.lastname: Nikolaev
mesh_terms: D001003:Anal Canal / Q000601:surgery*; D001746:Bladder Exstrophy / Q000150:complications*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D019736:Prostheses and Implants; D014547:Urinary Diversion / Q000009:adverse effects*; D014549:Urinary Incontinence / Q000209:etiology / Q000601:surgery*