Closure of the bladder neck in patients undergoing continent vesicostomy for urinary incontinence.

The continent vesicostomy has been done on 24 patients, 10 of whom had severe urinary incontinence requiring closure of the bladder neck or urethra as well. Therefore, the bladder was converted to a closed cavity and intermittent catheterization is done through an abdominal stoma. No dressings or appliances are necessary. Bladder neck (or urethral) closure was successful in 8 of the 10 patients. One of the failures had been incontinent and was rendered continent on attempted bladder neck closure and there is urethral leakage at night in the other patient. Intermittent catheterization through a vesicostomy stoma has been cleaner and more aesthetically pleasing to the patients. The bladder neck closure has resulted in a dry perineum with fewer skin problems.