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Improved Results Using a Modification of the Young‐Dees‐Leadbetter Bladder Neck Repair
Author(s) -
JONES J. A.,
MITCHELL M. E.,
RINK R. C.
Publication year - 1993
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1993.tb16024.x
Subject(s) - medicine , epispadias , silastic , neck of urinary bladder , surgery , bladder exstrophy , urinary continence , urology , urinary bladder , prostatectomy , prostate , cancer
Summary— Forty‐seven patients with primary total incontinence underwent bladder neck reconstruction (BNR) between 1978 and 1988. This included 31 patients with exstrophy/epispadias, 14 with myelomeningocele and 2 with caecoureteroceles. The patients were divided into 5 groups based on the type of BNR: Group 1—standard Young‐Dees‐Leadbetter (YDL.) BNR; Group 2—YDL. + Silastic sheath; Group 3—modified YDL.; Group 4—Kropp BNR; Group 5—other BNRs; Group 1 included 18 patients with a 45% primary continence failure rate, a 44% reoperation rate and only a fair ability to void spontaneously after BNR. There were 11 patients in Group 3 with a 9% primary continence failure rate, a 27% reoperation rate and excellent post‐operative emptying. None of the 3 patients in Group 4 was incontinent post‐operatively, but they all required reoperation and had poor post‐operative emptying. We feel that the modified YDL BNR provides better overall voiding and continence with less morbidity than the other bladder neck/urethral reconstructive procedures.