Management of urinary incontinence in girls with neurogenic bladder

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Abstract
The treatment in girls of urinary incontinence caused by a neurogenic bladder remains a challenge for the pediatric urologist. Of 527 patients with neurogenic bladder treated and followed in the Department of Pediatric Urology of Debrousse Hospital, between 1965 and 1989, 46 were submitted to continent cystostomy, 39 to urinary artificial sphincter and 177 to clean intermittent catheterization (CIC). This last treatment is of paramount importance in girls and can be associated with complementary procedures if the cervicourethral resistances and/or bladder compliance are poor. The urethral lengthening (Kropp's procedure) in combination with CIC represents a major means of providing dryness in girls. Our technique of urethral lengthening is detailed. The place of CIC among the other treatments of incontinence is discussed.