title: Urethral mini-sling for the treatment of neurogenic sphincteric incompetence in pediatric and young adult patients.
abstract: OBJECTIVE
  A first experience was carried out in three research centers using a new urethral sling for the treatment of male and female pediatric and young adult population with urinary incontinence caused by neurogenic sphincteric incompetence.
  
  
  METHODS
  This was a prospective pilot study of patients with neurogenic sphincteric incompetence needing clean intermittent catheterization. All patients were treated by the implantation of Nephis® mini-sling (Promedon, Argentina) over the proximal urethra. Twenty-eight patients were included, 19 females and 9 males. Mean age was 13.4 (SD 7.8 years). The median follow-up was 16.5 (12-24) months. Urodynamic studies were carried out pre and postoperatively to assess the nature of the incontinence and to quantify the outcomes after implantation. A voiding diary was also used to evaluate the Daytime Dryness Intervals between catheterization.
  
  
  RESULTS
  Leak Point Pressure increased from a preoperative mean value of 24.3 cmH2O (SD 6.5) to 51.0 cmH2O (SD14.3) (p<0.0005). The initial mean for Daytime Dryness Interval was 60.4min (SD 9.1) and postoperatively rose to 195.6 (SD 59.4) (p<0.0005). Only one major complication was registered: a sling had to be removed due to erosion in a patient who underwent a concomitant bladder neck reconstruction due to an ectopic ureter repair.
  
  
  CONCLUSIONS
  The mini-sling was easy to implant and urodynamic results suggest it is effective in the treatment of neurogenic sphincteric incompetence. This statement is also supported by voiding diary records.
authors: Sanatorio del Salvador, Córdoba, Argentina.
authors: Angel
authors: A
authors: García Fernández
authors: Roberto
authors: R
authors: Vagni
authors: Jorge
authors: J
authors: García Andrade
authors: Mariana
authors: M
authors: Flores
authors: Luis
authors: L
authors: Sentagne
authors: Francisco
authors: F
authors: Badiola
mesh_terms: D000328:Adult; D002648:Child; D006801:Humans; D010865:Pilot Projects; D011446:Prospective Studies; D053825:Suburethral Slings; D001750:Urinary Bladder, Neurogenic / Q000601:surgery; D014549:Urinary Incontinence; D055815:Young Adult