The rectus myofascial wrap in the management of urethral sphincter incompetence

G. C. Mingin, K. Youngren, J. A. Stock, M. K. Hanna

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Objective: To review our experience with a modified rectus/pyramidalis myofascial sling, described more than a century ago for treating refractory urinary incontinence in children with neurogenic sphincteric incompetence. Patients and methods: Thirty-seven patients (23 females and 14 males, aged 8-21 years) presented with urinary incontinence which failed to respond to medical treatment. In 36 patients the cause of the incontinence was a neurogenic bladder; one patient had sustained a traumatic injury to the bladder neck and urethra. Patient selection was based on videocystourethrographic detection of an incompetent bladder neck, and a low maximum closure pressure during urethral pressure profilometry. The bladder was augmented in 33 of the 37 patients. Results: Of the 37 patients, 34 (92%) are dry between catheterizations; the follow-up was 0.5-10 years. Two of the male patients continued to have persistent incontinence requiring bladder neck closure and creation of a continent stoma. One of the female patients developed stress incontinence after 4 years of being dry, with a rectus sling. Conclusion: The rectus myofascial sling provides long-term satisfactory dry intervals between catheterizations in patients with neurogenic sphincteric incompetence. The cinch-wrap modification appears to enhance the occlusive effect of the sling, particularly in males.

Original languageEnglish
Pages (from-to)550-553
Number of pages4
JournalBJU International
Volume90
Issue number6
DOIs
StatePublished - 2002
Externally publishedYes

Keywords

  • Fascial sling
  • Neurogenic bladder
  • Urinary incontinence

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