Closure of the bladder Neck in Spinal Cord Injury Patients with Urethral Sphincteric Incompetence and Irreparable Urethral Pathological Conditions

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Abstract
Total urinary incontinence developed secondary to incompetence of the urethral closing mechanism in 8 spinal cord injury patients who were on Foley catheter drainage (5 patients) or suprapubic cystostomy (3 patients). All patients had irreparable urethrocutaneous fistulas and 4 had urethroperineal erosion. Closure of the bladder neck with drainage via a suprapubic cystostomy tube was used to divert the urinary stream. Bladder neck closure was successful in alleviating total urethral urinary incontinence in all patients. Suprapubic abdominal leakage developed in 2 patients. This procedure shoud be recommended cautiously when a maximal bladder capacity > 125 cc cannot be maintained unless concomitant augmentation cystoplasty also is considered.