Outcomes of bladder neck closure for intractable stress urinary incontinence
BAUS ePoster online library. Mosli-lynch C. Jun 27, 2018; 211393
Mr. Conor Mosli-lynch
Mr. Conor Mosli-lynch
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Abstract
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Introduction: Bladder Neck Closure (BNC) is an infrequently performed for intractable urinary incontinence as a 'last resort', in patients whom other options have been exhausted. Two main approaches -Transabdominal and Transvaginal are described. We have assessed the outcomes of these different techniques.

Methods: We retrospectively examined 38 patients who had BNC performed between 1995 and 2016 in a single unit. Examined were demographics, underlying diagnosis, technique and whether concurrent bladder augmentation or urinary diversion was performed. Outcomes included success of procedure, continence at one year and need for revision; analysed using Fisher's Exact Test.

Results: Results are shown on table 1.The Transabdominal route was the most frequently employed (73%, n=19), often concurrent to Augmentation Cystoplasty and either Mitrofanoff (95%) or SPC (5%). Success rate was 72% at one year. Transvaginal approach was used in 27% (n=7) with a Martius fat pad employed in 83%. The success rate for transvaginal approach was 57% (n=4). There was no significant difference demonstrated between the two routes with regards to success of closure, continence at one year or the need for revision.

Conclusion: Bladder neck closure results in a 76% success rate. There was no statistical difference in outcome between the two approaches, and the best technique remains dependent on the indications for BNC and the ability to access the bladder neck from above or below the pelvis.

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