Rink R C, Mitchell M E
J Pediatr Surg. 1984 Dec;19(6):637-41. doi: 10.1016/s0022-3468(84)80346-2.
Over the last 6 years, 114 patients have undergone surgery for urinary incontinence. The majority (79%) had neurologic dysfunction of the bladder because of spinal malformation (myelodysplasia, sacral agenesis, or trauma) and the remaining were a mixed group including exstrophy/epispadias, urethral valves, pelvic fractures, etc. The patients were grouped in six categories. Those with lower urethral resistance underwent bladder neck reconstruction with Young-Dees-Leadbetter procedure (five patients) or had placement of an artificial urinary sphincter (27 patients). Those with poor bladder compliance underwent primary bladder augmentation (21 patients). Those with combined urethral problems and poor compliance had combined procedures (14 patients). Thirty-seven patients previously diverted for incontinence and undergoing undiversion were considered separately, as were ten patients without any bladder precluding preoperative assessment. Of the entire group, continence was achieved in 83 patients with the initial procedure (73%). Secondary procedures have resulted in continence in 101 patients (89%). Three patients were improved but unsatisfactory, and nine remain wet; one is unknown.
在过去6年中，114例患者接受了尿失禁手术。大多数患者（79%）因脊柱畸形（脊髓发育不良、骶骨发育不全或外伤）导致膀胱神经功能障碍，其余患者为混合组，包括膀胱外翻/尿道上裂、尿道瓣膜、骨盆骨折等。患者被分为六类。尿道阻力较低的患者接受了Young-Dees-Leadbetter手术进行膀胱颈重建（5例患者）或植入人工尿道括约肌（27例患者）。膀胱顺应性差的患者接受了一期膀胱扩大术（21例患者）。合并尿道问题和顺应性差的患者接受了联合手术（14例患者）。37例先前因尿失禁而行改道术且正在接受改道回原手术的患者以及10例无任何膀胱问题而无需术前评估的患者被单独考虑。在整个组中，83例患者通过初始手术实现了控尿（73%）。二次手术使101例患者实现了控尿（89%）。3例患者情况有所改善但仍不理想，9例患者仍有尿失禁；1例情况不明。
