Suprapubic Bladder Neck Suspension for the Management of Urinary Incontinence in the Myelodysplastic Girl

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Abstract
Four young girls with myelodysplasia who remained incontinent despite intermittent catheterization and pharmacological manipulation underwent suprapubic bladder neck suspension along with bladder augmentation. Of the patients 3 underwent augmentation for decreased detrusor compliance and 1 as a part of a planned urinary undiversion. There was a mean increase in continence length of 1 cm. and a mean increase of 49 cm. water in urethral closure pressure in all patients. All patients currently are dry on intermittent self-catheterization and oxybutinin chloride with a minimum followup of 18 months with no evidence of upper tract deterioration. Therefore, suprapubic bladder neck suspension can be used successfully in the female patient with decreased outlet resistance. The procedure is easy to perform and would be easily reversible should incontinence recur and a further operation be required.