Comparing outcomes of slings with versus without enterocystoplasty for neurogenic urinary incontinence.
OBJECTIVE
We compared 2 cohorts of children with neurogenic urinary incontinence undergoing bladder neck sling with and without augmentation to determine relative continence outcomes, catheterization intervals, anticholinergic requirements and health related quality of life improvement as perceived by the patients and their parents.


METHODS
Consecutive patients followed through our spina bifida program underwent a structured postoperative interview by a research nurse to assess continence, interval between catheterizations and anticholinergic use. In addition, the child and parent together answered a health related quality of life satisfaction survey to determine the impact of surgery from their perspectives.


RESULTS
There were 18 patients undergoing sling with augmentation and 23 with sling alone. Overall improved continence rate was 83%, with no difference between outcomes in patients with vs without augmentation. However, the interval between catheterizations was longer and the use of anticholinergics was less following augmentation. Nevertheless, health related quality of life responses differed significantly in only 1 area, independent care, with both cohorts reporting similarly improved overall health, and increased ability to participate in social and leisure activities.


CONCLUSIONS
We directly compared results in patients undergoing slings with and without augmentation. Both procedures were similarly successful in achieving improved continence, with patients undergoing augmentation having a longer interval between catheterization and requiring fewer anticholinergics. However, health related quality of life responses revealed that both cohorts were similarly satisfied with the outcomes.
Snodgrass
Warren
W
Pediatric Urology Section, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75207, USA. warren.snodgrass@childrens.com
Keefover-Hicks
Amy
A
Prieto
Juan
J
Bush
Nicol
N
Adams
Richard
R
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007422:Intestines / Q000637:transplantation*; D008297:Male; D053825:Suburethral Slings; D001743:Urinary Bladder / Q000601:surgery*; D001750:Urinary Bladder, Neurogenic / Q000150:complications*; D014549:Urinary Incontinence / Q000209:etiology* / Q000601:surgery*