Pubovaginal Sling Procedure for the Management of Urinary Incontinence in a Myelodysplastic Girl

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Abstract
Urinary incontinence is a formidable social handicap in many children with myelodysplasia. Girls in whom pharmacologic therapy and intermittent catheterization fail to alleviate incontinence present particularly difficult management problems. Permanent catheter drainage of the bladder or supravesical urinary diversion frequently was used solely for control of incontinence. More recently, the artificial sphincter has been used in selected patients. The use of a pubovaginal sling to augment bladder outlet resistance in a girl with myelodysplasia is described. Postoperatively, she remains totally continent on intermittent catheterization.