title: A comparative study between continent diversion and bladder neck closure versus continent diversion and bladder neck reconstruction in children.
abstract: OBJECTIVE
  To assess the long-term outcome of continent diversion in children with structural or neurogenic cause of incontinence, with special interest in differences between closed and open bladder neck procedures.
  
  
  METHODS
  A cohort of 63 children with intractable incontinence treated with continent diversion between January 1998 and January 2008 were reviewed for underlying disease, type of surgery, complications and outcome.
  
  
  RESULTS
  Forty patients had a continent diversion with open bladder neck (group 1) and 23 patients had their bladder neck closed (group 2: 11 primarily closed; 12 secondarily closed). There was no difference between the two groups in terms of patient characteristics, surgical re-interventions and stone formation. The continence rate however was significantly better in group 2 (95.6% vs 77.5%).
  
  
  CONCLUSIONS
  Bladder neck closure with continent diversion as primary or salvage procedure in children with intractable incontinence does not result in extra morbidity and has a high success rate. Thorough urodynamic evaluation of bladder function is the key to success in therapy planning for these children, to minimize the need for re-intervention.
authors.affiliation: Department of Urology & Paediatric Urology, Ghent University Hospital, Ghent 9000, Belgium.
authors.forename: Bart
authors.initials: B
authors.lastname: De Troyer
authors.forename: Erik
authors.initials: E
authors.lastname: Van Laecke
authors.forename: Luitzen A
authors.initials: LA
authors.lastname: Groen
authors.forename: Karel
authors.initials: K
authors.lastname: Everaert
authors.forename: Piet
authors.initials: P
authors.lastname: Hoebeke
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*; D014549:Urinary Incontinence / Q000601:surgery*; D016476:Urinary Reservoirs, Continent