Long-Term Outcome of the Pippi Salle Procedure for Intractable Urinary Incontinence in Patients with Severe Intrinsic Urethral Sphincter Deficiency

Nakamura, Shigeru; Hyuga, Taiju; Kawai, Shina; Nakai, Hideo

doi:10.1016/j.juro.2015.05.095

Cited by 13 publications

(3 citation statements)

References 19 publications

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“…Nakamura et al (38) reported results of the Salle procedure in 12 children (9 with NSBD) Seven were completely dry (58%) at a mean follow-up time of 75 months. Three had experienced difficulties with urethral catheterization.…”

Section: Resultsmentioning

confidence: 99%

Surgical Management of Neurogenic Sphincter Incompetence in Children

et al. 2019

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We report on the results of a literature review regarding the indications and results of operations to increase bladder outlet resistance to achieve dryness in children with neurogenic sphincter incompetence (NSBD). The relative advantages and disadvantages of injection of bulking agents, periurethral slings, bladder neck reconfiguration, artificial sphincters, and bladder neck closure based on a literature review and our combined clinical experience are discussed. Based on this review and our experience, we propose that periurethral injection of bulking agents is not justified as a primary treatment. Likewise, operations that reconfigure the bladder neck are not very useful since most patients also require bladder augmentation and an abdominal catheterizable channel. Bladder neck slings with autologous tissues are effective, mostly in females bur in the majority of patients a bladder augmentation is necessary. There is a role also for implantation of artificial urinary sphincters but when done as an isolated procedure, close monitoring to detect possible detrusor changes is needed. Bladder neck closure is an effective measure when other methods have failed.

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Section: Resultsmentioning

confidence: 99%

Surgical Management of Neurogenic Sphincter Incompetence in Children

et al. 2019

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“…Evidence in SCI patients is insufficient for establishing specific recommendations. In the series of Nakamura et al, [6] one female SCI patient with severe intrinsic urethral sphincter deficiency achieved complete dryness in the long run. In the total group difficulty of catheterizing through the urethra (25%), and urinary calculi (8%) were complicating factors.…”

Section: Bladder Neck Reconstructionmentioning

confidence: 94%

Surgical management of the neurogenic bladder after spinal cord injury

et al. 2018

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“…The original technique described by Young-Dees-Leadbetter was modified in recent decades by different urological surgeons mainly in pediatric patients with bladder extrophy [206,[211][212][213][214]. These techniques provide continence rates of 50-94% [206,207,211,215,216]. However, such bladder neck/urethral reconstructions require regular ISC to empty the bladder and often prior or simultaneous bladder augmentation to secure low pressure storage [217].…”

Section: Bladder Neck/urethral Reconstructionmentioning

confidence: 99%

The Management of Urine Storage Dysfunction in the Neurological Patient

Mehnert

2018

SN Compr. Clin. Med.

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To highlight the current aspects and developments in the management of neurogenic urine storage dysfunction and to sensitize urologists for this interdisciplinary and important topic. Neurogenic lower urinary tract dysfunction affects a large proportion of patients with chronic neurological diseases or lesions such as multiple sclerosis, Parkinson's disease, stroke, spina bifida, and spinal cord injury. Such a dysfunction is not only highly bothersome and devastating for the quality of life but also poses a significant risk for health. Particularly, detrusor overactivity and detrusor-sphincterdyssynergia are frequent pathological patterns in neurogenic lower urinary tract dysfunction that are associated with sequelae such as recurrent urinary tract infections and renal impairment. The current cornerstones of treatment for urine storage dysfunction in neurological patients such as intermittent self-catheterization, antimuscarinic drugs, botulinum neurotoxin A intradetrusor injections, augmentation cystoplasty, urinary diversion, and artificial urinary sphincter have significantly contributed to improvements in QoL, health, and survival of neurological patients affected by neurogenic lower urinary tract dysfunction. However, these treatments have not advanced much recently. Moreover, the level of evidence of many therapy options specifically regarding their application in neurological patients is quite low and the main and auxiliary mechanisms of action are often only poorly understood. Despite former accomplishments in Neuro-Urology, more specific evidence for treatments of lower urinary tract dysfunction in neurological patients as well as better knowledge on their mechanisms of action is needed to advance the field and exploit the full treatment potential of available therapies.

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Long-Term Outcome of the Pippi Salle Procedure for Intractable Urinary Incontinence in Patients with Severe Intrinsic Urethral Sphincter Deficiency

Abstract: Although we experienced some minor complications in the short term, most patients were simply and successfully treated with endoscopic surgery. The long-term results of the Pippi Salle procedure are promising.

Cited by 13 publications

References 19 publications

Surgical Management of Neurogenic Sphincter Incompetence in Children

Surgical Management of Neurogenic Sphincter Incompetence in Children

Surgical management of the neurogenic bladder after spinal cord injury

The Management of Urine Storage Dysfunction in the Neurological Patient

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