Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Incontinence Pads”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 847 records · Page 47Linked to original sources
PubMed2001

Ultrasonographic and urodynamic evaluation after tension free vagina tape procedure (TVT).

BACKGROUND: This study was carried out to evaluate the urodynamic and ultrasonographic findings after tension-free vagina tape (TVT) procedure on stress urinary incontinent women. METHODS: Ninety women suffering from genuine stress incontinence without pelvic relaxation syndrome underwent surgery. Urodynamic measurement, one-hour pad test and introital ultrasonographic evaluation were performed preoperatively and one year after surgery. Additional ultrasonographic surveillance of the urethra was performed immediately after the operation. The position and mobility of the bladder neck was compared pre- and post-operatively in relation to the inferior edge of the pubic symphysis. RESULT: Eight women were excluded for various reasons. Among the 82 women who completed the study, 76 (93%) were cured, four were improved and two failed. No major intra- or post-operative complications occurred. The position and mobility of the bladder neck showed no significant difference before and after surgery. A urethral knee angle was noted ultrasonographically on cured and improved patients during maximum straining. Nine patients with immediate postoperative voiding difficulty were found to have a pronounced mid-urethra angulation. The symptom and sign were resolved by time after urethra depressing. Urodynamic assessment of the urethral pressure profile and other parameter showed no significant difference before and after the surgery except that a positive pressure transmission in the middle portion of the urethra was noted among 70 (87.5%) of cured and improved subjects. CONCLUSION: Tension-free vagina tape operation is an effective surgical procedure for the treatment of female urinary stress incontinence. The procedure seems neither to change hypermobility nor to elevate the position of bladder neck. Urinary continence after surgery is most probably achieved by creating a dynamic mid-urethral knee angulation by which the urethra is closed i.e. kinked at stress. Lifting of the mid-urethra resulted in postoperative voiding difficulty. It is the important that the tape is placed tension free under the urethra. Introital ultrasonographic surveillance is a suitable technique to visualize the result of the operation.

Adult↗
PubMed2001

The effects of severe cystocele on urogynecologic symptoms and findings.

BACKGROUND: To evaluate the effects of severe cystocele on lower urinary tract function. METHODS: Urogynecologic evaluation composed of patient questionnaire, urinary diary, pad test, Q-tip test, perineal ultrasonography and cystometry was performed on 60 patients with reducible grade III or IV cystocele before and after reduction of the prolapsed organs. The data were analyzed by Paired-t and Chi-square tests and Pearson's correlation analysis. RESULTS: One-hour pad test revealed that 17 (28.3%) of the 60 patients with reducible severe cystocele had no demonstrable urinary incontinence, while 26 (43.3%) had mild and 17 (28.3%) had moderate or severe incontinence. However, all patients had moderate or severe incontinence after reduction with vaginal packing (p<0.001). The vaginal packing had no significant effect on the maximum bladder capacity, the intravesical pressure at maximum capacity and the frequency of detrusor instability (33.3%). Whereas, urine loss after 1-hour pad test, bladder neck mobility, straining Q-tip angle and PUVA increased significantly after reduction of the cystocele (p<0.01). CONCLUSIONS: As grade III or IV cystocele may mask the presence and severity of urinary stress incontinence, preoperative urogynecological evaluation should be done after reduction of the cystocele.

Adult↗
PubMed2001

Correlation of urethral closure pressure, leak-point pressure and incontinence severity measures.

The aim of this study was to determine whether water perfusion maximum urethral closure pressure (MUCP) correlates with Valsalva leak-point pressure (LPP), and which of these best correlates with subjective and objective incontinence severity measures. Fifty-two women with previously diagnosed genuine stress incontinence (n = 46), or mixed incontinence with a minor and controlled urge component (n = 6), were assigned an incontinence status grade based on interview and diary review. These women then completed visually observed standing LPPs at 250 ml bladder capacity, supine water perfusion MUCP determinations, pad tests and quality of life questionnaires. The urodynamic and severity measures were compared with correlation analysis or analysis of variance. A modest correlation exists between LPP and MUCP (r = 0.50-0.62, P < 0.001). Both MUCP and LPP demonstrated significant decreases (P < 0.01) with increasing severity of assigned incontinence grade. A very low and insignificant correlation existed for these urodynamic parameters and pad loss or quality of life measures. MUCP and LPP correlate modestly with each other and both are comparable in predicting incontinence severity. Either can be used as the urodynamic measure to assess intrinsic sphincter deficiency.

Adult↗
PubMed1998

Results of the anti-incontinence operations and Kegel exercises in patients with type II anatomic stress incontinence.

BACKGROUND: To evaluate the results of anti-incontinence operations and Kegel exercises in patients with pure type II anatomic stress incontinence. METHODS: After evaluation by physical, genitourinary and urologically oriented neurological examinations, urogynecologic tests, perineal ultrasonography and cystometry, pure type II anatomic stress incontinence was diagnosed in 98 patients. Modified Pereyra and Burch operations were performed in 27 and 24 of the 51 (52.0%) patients, who had surgical treatments, respectively, while the remaining 47 (48.0%) patients were advised to perform Kegel exercise. The results of the treatment methods were evaluated subjectively by patient questionnaire and 24-hour urinary diary and objectively by one-hour pad test and stress test. RESULTS: Fifty-one patients treated by anti-incontinence operations had 90.2% objective and 94.1% subjective complete successes (cure) with a mean follow-up of 13.7 months. These data were 8.5% and 14.9% respectively, for 47 patients treated by Kegel exercises with a mean follow-up of 12.8 months. Both the subjective and objective cure rates of surgical treatments were found to be significantly higher than those of Kegel exercises in patients with type II anatomic stress incontinence (p<0.01). Patients with good compliance to Kegel exercises had 20.7% subjective and 13.8% objective cures, however those with low compliance had only 5.6% subjective and no objective cures. CONCLUSIONS: These data suggested that anti-incontinence operations were more effective than Kegel exercises for the treatment of patients with type II anatomic stress incontinence.

Adult↗
PubMed1994

[Submucous urethral augmentation in stress incontinence. Indications and results].

An endoscopic transurethral collagen implantation was performed in 45 women, suffering from mostly recurrent stress incontinence. No complications have been observed. The results were measured by a standardized PAD weight test. After 6 months, 17 women were cured and 21 were improved; after 12 months, 14 patients were still completely dry and 21 were improved (nearly 80% success rate). Using silicone particles in a lubricating carrier gel (Macroplast), even better and persisting results are expected.

Adult↗
PubMed1999

Reconstruction of rectovaginal fistula with sphincter disruption by combining rectal mucosal advancement flap and anal sphincteroplasty.

PURPOSE: This study evaluated the effectiveness of combining advancement flap with sphincteroplasty in patients symptomatic with rectovaginal fistula and anal sphincter disruption. METHODS: Twenty patients with rectovaginal fistulas and anal sphincter disruptions after vaginal deliveries underwent combined rectal mucosal advancement flap and anal sphincteroplasty between July 1986 and July 1993. The mean age of the patients was 30 (range, 18-40) years and the mean duration of symptoms was 54.8 weeks (range, 7 weeks to 6 years). In addition to mucosal advancement flap repair, 13 patients underwent two-layer repair of anal sphincters (with reapproximation of the puborectalis in 8 of the patients); 6 patients underwent one-layer overlap repair of anal sphincters (with reapproximation of the puborectalis in 2 of the patients); and 1 patient underwent reapproximation of internal anal sphincter alone because squeeze pressures were adequate, as determined by anal manometry. RESULTS: Postoperatively, vaginal discharge of stool and flatus was eliminated entirely in all 20 patients. Perfect anal continence of stool and flatus was restored in 14 patients (70 percent). Incontinence was improved but not eliminated in six patients (4 incontinent to liquid stool and 2 to flatus), and two patients required perineal pads. Subjectively, 19 patients (95 percent) reported the result as excellent or good. There were no complications. CONCLUSION: The combination of mucosal advancement flap and anal sphincteroplasty is a safe and highly effective procedure for correcting rectovaginal fistula with sphincter disruption after obstetrical injuries.

Adolescent↗
PubMed1996

Evaluation of a questionnaire in the assessment of patients with faecal incontinence and constipation.

BACKGROUND: A self-reported questionnaire may be a useful instrument in assessing patients with faecal incontinence and constipation. METHODS: Reliability, discrimination, validity, and sensitivity were evaluated in 16 control subjects 36 patients with faecal incontinence, and in 38 with constipation. The reliability was measured by a test-retest procedure (kappa (kappa) statistics or Spearman rank test), and validity by comparing the questionnaire and a diary. Discrimination was assessed by comparing the patient groups with the controls, and sensitivity by comparing selected answers before and after treatment. RESULTS: Overall reliability (faecal incontinence group, mean kappa = 0.57; constipation group, mean kappa = 0.60; controls, mean kappa = 0.95) and validity were judged acceptable. In the incontinence group occurrence of faecal incontinence per se was reproducible (kappa = 0.66), as was the need to wear a pad (kappa = 0.85). Stool frequency, percentage toilet time spent straining and digitation was reproducible in patients with constipation (kappa = 0.80, r = 0.56; p < 0.001, kappa = 0.83 respectively). Several items distinguished both patient groups from healthy controls (p < 0.05 to p < 0.001). Sensitivity to surgical treatment was seen in several items in both patient groups. CONCLUSIONS: The questionnaire appears to be a valid measure of symptoms in faecal incontinence and constipation with sufficient discriminatory capacity.

Case-Control Studies↗
PubMed1984

Assessment and quantification of urine loss in incontinent women.

Urinary incontinence is a common symptom that frequently causes women embarrassment, loss of self-esteem and physical problems such as vulvar irritation. It is, therefore, important to accurately assess incontinence in order to offer appropriate treatment. This article provides an overview of incontinence, as well as the assessment and treatment of the incontinent woman. Two versions of a simple, objective measure of urine loss, called a pad test, are presented. The article concludes with a brief discussion of non-surgical interventions which can be initiated and managed by the nurse practitioner.

Administration, Topical↗
PubMed2002

Radio-frequency energy delivery to the anal canal for the treatment of fecal incontinence.

PURPOSE: In this prospective study we investigated the feasibility, safety, and efficacy of radio-frequency energy delivery deep to the mucosa of the anal canal for the treatment of fecal incontinence. METHODS: We studied ten patients with fecal incontinence of varying causes. All patients underwent anoscopy, anorectal manometry, endorectal ultrasound, and pudendal nerve terminal motor latency testing at baseline and six months. The Cleveland Clinic Florida scale for fecal incontinence (Wexner, 0-20), fecal incontinence-related quality of life score, and Short Form 36 were administered at baseline, 1, 2, 3, 6, and 12 months. Using conscious sedation and local anesthesia, we delivered temperature-controlled radio-frequency energy via an anoscopic device with multiple needle electrodes to create thermal lesions deep to the mucosa of the anal canal. RESULTS: Ten females (age, 55.9 +/- 9.2 years; range, 44-74) were enrolled and treated. Median discomfort by visual analog scale (0-10) was 3.8 during and 0.9 two hours after the procedure. Bleeding occurred in four patients (14-21 days after procedure), spontaneous resolution (n = 3) and anoscopic suture ligation (n = 1). At 12 months, the median Wexner score improved from 13.5 to 5 (P < 0.001), with 80 percent of patients considered responders. All parameters in the fecal incontinence-related quality of life were improved (lifestyle (from 2.3 to 3.4), coping (from 1.4 to 2.7), depression (from 2.2 to 3.5), and embarrassment (from 1.3 to 2.8); P < 0.05 for all parameters). Protective pad use was eliminated in five of the seven baseline users. At six months, there was a significant reduction in both initial and maximum tolerable rectal distention volumes. Anoscopy was normal at six months. CONCLUSION: Radio-frequency energy delivery to the anal canal for treatment of fecal incontinence is a new modality that, in this study group, safely improved Wexner and fecal incontinence-related quality of life scores, eliminated protective pad use in most patients, and improved patient quality of life.

Adult↗
PubMed2004

Morbidity and functional outcomes of salvage radical prostatectomy for locally recurrent prostate cancer after radiation therapy.

PURPOSE: Few patients with locally recurrent prostate cancer after external beam (EB) or interstitial (I) radiotherapy (RT) are considered candidates for salvage radical prostatectomy (RP) due to high reported rates of major complications and urinary incontinence. We report the morbidity associated with salvage RP in 100 consecutive patients. MATERIALS AND METHODS: From 1984 to 2003 salvage RP was performed for recurrent prostate cancer following EBRT in 58 cases, and IRT in 42 (28 retropubic) and (14 transperineal). Clinical information was obtained from a prospective database. RESULTS: Since 1993, the major complication rate has decreased significantly (13% vs 33%, p = 0.02), including the rectal injury rate (2% vs 15%, p = 0.01). Compared with retropubic IRT and/or pre-radiotherapy pelvic lymph node dissection the risk of major complications following EBRT or transperineal IRT was significantly less (OR 0.2, p = 0.006). At 5 years an estimated 39% of patients were dry and 68% required 1 pad daily or less. A total of 23 patients with moderate-severe incontinence underwent artificial sphincter placement. The anastomotic stricture rate was 30%. The 5-year potency rate was 28% following unilateral or bilateral nerve sparing RP and 45% in previously potent patients. CONCLUSIONS: Due to patient selection the major complication rate after salvage RP has improved significantly with time and it is similar to that of standard RP. Rates of anastomotic stricture and moderate to severe incontinence are higher than those observed after standard RP. However, most patients recover reasonable urinary continence and a substantial number of select patients recover potency. The acceptable morbidity profile of salvage RP following EBRT and transperineal IRT should persuade more physicians to consider patients for this potentially curative procedure.

Aged↗
PubMed2006

[Urinary incontinence restrictions in women's life].

Our purpose with this study was to verify the restriction of the urinary incontinence (UI) in a woman's daily life, considering the type of incontinence, and find out how women deal with that. It is a secondary analysis of data taken from a previous study that were obtained using open and closed questions. Interviews were held with 164 incontinent inpatients of gynecological and urological clinics of two hospital schools in the city of Campinas, in the State of São Paulo, with ages ranging from 25 to 85 years. Of this universe, 104 (64%) indicated one or more restrictions regarding their daily life activities, such as altered sexual (40.9%), social (33.5%), domestic (18.9%) and occupational activities (15.2%). Mixed urinary incontinence and urge incontinence were mentioned as that affected the most women's daily life. The disposable pad system was the most utilized strategy in dealing with UI. It was concluded that UI has a negative impact on the daily life of these women.

Adult↗
PubMed1989

Doxepin in the treatment of female detrusor overactivity: a randomized double-blind crossover study.

A total of 19 women with detrusor overactivity and associated symptoms completed a double-blind placebo-controlled crossover study of doxepin. All patients had previously failed to respond to conventional pharmacotherapy. Doxepin was given at bedtime in a single 50 mg. dose for the first 2 weeks and, if needed, the dose was increased with 25 mg. in the morning for the last week of the 3-week treatment period, which was followed by 2 weeks of washout before crossover. The preference for doxepin to placebo was statistically significant (p less than 0.01). Doxepin caused a significant decrease in the nighttime micturition frequency and the nighttime incontinence episodes (p less than 0.05). Urine loss at the standardized 1-hour pad weighing test decreased significantly during treatment with doxepin although statistical significance (p equals 0.07) was not obtained. Cystometric parameters (first sensation and maximum cystometric capacity) improved significantly during treatment with doxepin (p less than 0.06 and less than 0.04, respectively). Side effects were frequent but mild. Suggestions for use of this tricyclic antidepressant in women with detrusor overactivity and possible mechanisms of action are discussed.

Adult↗
PubMed2004

Pelvic floor maximal strength using vaginal digital assessment compared to dynamometric measurements.

AIM: To compare vaginal digital assessment with dynamometric measurements for determining the maximal strength of the pelvic floor muscles (PFM). MATERIALS AND METHODS: Eighty-nine women aged between 21 and 44 participated in the study. An experienced physiotherapist evaluated the maximal strength of the PFM of these women using the modified Oxford grading system (six categories, range 0-5) and dynamometric measurements. The mean maximal forces obtained for all women with the instrumented speculum for each category of digital assessment were compared using ANOVAs. Spearman's rho coefficients were calculated to assess the correlation between the dynamometric and the digital assessments. RESULTS: According to their symptoms and pad test results, 30 women were continent and 59 had stress urinary incontinence (SUI). Based on dynamometric measurements, important overlaps were observed between each category of digital assessment. The ANOVAs indicated that force values differ across categories (F = 10.08; P < 0.001), although contrast analyses revealed no differences in the mean maximal forces between adjacent digital-assessment categories (1-2, 2-3, 3-4, 4-5). Mean force values differed significantly only between non-adjacent levels in digital assessment, for example, between 1 and 3; 1 and 4; 1 and 5; 2 and 4; 2 and 5 (P < 0.05). Significant correlations were found between the two measurements with coefficients of r = 0.727, r = 0.450, and r = 0.564 for continent, incontinent, and all women, respectively (P < 0.01). CONCLUSIONS: Even if the dynamometric mean forces of the PFM increased across subsequent categories of digital assessment, the force values between two adjacent categories do not differ. This limitation of digital assessment should be considered by clinicians and researchers when choosing treatment orientation and evaluating treatment outcomes.

Adult↗
PubMed2002

Urinary continence outcome after augmentation ileocystoplasty as a single surgical procedure in patients with myelodysplasia.

PURPOSE: Preoperative prediction of urinary continence in patients with myelodysplasia requiring augmentation cystoplasty is uncertain. To determine reliable factors to predict postoperative urinary continence, we retrospectively analyzed preoperative videourodynamic parameters and urinary continence outcome in a group of patients with myelodysplasia who underwent augmentation ileocystoplasty. MATERIALS AND METHODS: Of 75 patients with myelodysplasia with neurogenic bladder dysfunction refractory to conservative management (anticholinergic drugs and clean intermittent catheterization) who underwent augmentation cystoplasty as a single procedure we selected 14 girls and 12 boys without previous vesicostomy drainage and with preoperative and postoperative videourodynamic studies in whom detubularized ileocystoplasty was performed. Preoperative and postoperative evaluation included physical examination, assessment of renal function, urine culture, renal and bladder ultrasound and videourodynamic studies. We analyzed on preoperative videourodynamic studies bladder outlet morphology at 20 cm. water of filling detrusor pressure, leak point pressure, cystometric bladder capacity and end filling detrusor pressure. Videourodynamic bladder outlet morphology was classified as closed bladder outlet, insinuated bladder neck, bladder neck and urethra open up to the sphincter, and bladder outlet widely open. Patients were considered continent if they were able to remain dry between catheterization without pads. For analysis patients were divided into group 1-19 with preoperative incontinence and group 2-7 without urinary incontinence. RESULTS: After surgery 4 group 1 patients had urinary incontinence whereas all group 2 patients remained continent. Only 1 group 1 patients with leak point pressure less than 50 cm. H2O and 3 with leak point pressure greater than 50 cm. H2O were incontinent after surgery. Seven group 1 patients with cystometric bladder capacity greater than 75% and 8 with cystometric bladder capacity less than 75% of the age expected bladder capacity achieved continence. Two group 1 patients with filling detrusor pressure less than 40 cm. H2O and 2 with filling detrusor pressure greater than 40 cm. H2O continued with urinary incontinence after ileocystoplasty. Preoperative videourodynamic images of the 4 group 1 patients who remained incontinent after surgery demonstrated irrespective of the aforementioned urodynamic parameter widely open bladder outlet. Moreover, none of the postoperative continent patients had an open bladder neck and urethra on preoperative evaluation. CONCLUSIONS: According to our findings of the anatomical morphology of the bladder outlet (bladder neck/urethra) during the filling phase of videourodynamic studies at 20 cm. water filling detrusor pressure was the most reliable parameter to predict continence outcome after detubularized augmentation ileocystoplasty.

Adolescent↗
PubMed1997

GAX collagen in the treatment of urinary incontinence in elderly women: a two year follow up.

OBJECTIVE: To determine the efficacy of GAX collagen in the treatment of elderly women with genuine stress incontinence. DESIGN: A single centre prospective study. SETTING: A London teaching hospital. PARTICIPANTS: Thirty-four women older than 60 years of age with genuine stress incontinence diagnosed on videocystourethrography. INTERVENTIONS: Up to three paraurethral injections of GAX collagen. MAIN OUTCOME MEASURES: Subjective and pad test assessments performed pre-operatively, after one month, one year and two years after the first injection of collagen. Videocystourethrography and urethral pressure profilometry were carried out pre-operatively, after three months and one year. RESULTS: There was a reduction in urinary leakage as measured on pad testing. After two years 77% of the surviving 26 women were symptomatically cured. Objectively after two years 48% of the women were cured and 9% were improved over their initial pre-treatment level of incontinence. The cure rate was the same whether or not the women had undergone previous vaginal surgery. The maximum urethral closure pressure was not increased with treatment indicating that collagen injections do not act by producing obstruction, but this should be interpreted with caution due to the small sample size. CONCLUSION: GAX collagen is an effective method of treating urinary incontinence in the elderly and especially women who have undergone previous continence procedures. The technique is easy to perform and particularly suitable in those who are frail, but if failure occurs after two years consideration needs to be given to its cost effectiveness.

Aged↗
PubMed2006

[Holmium laser enucleation of the prostate: the Kobe City General Hospital experience].

Between October 2004 and August 2005, 43 patients with the mean age of 70.9 (ranging 57-83) years, who had lower urinary tract symptoms underwent holmium laser enucleation of the prostate (HoLEP) at our hospital. The mean operative time, change in hemoglobin and resected tissue weight were 193 (83-390) minutes, -2.1 (-5.3 -/+ 1.3) g/dl and 40.2 (6.3-90.9) g, respectively. The mean postoperative urethral catheter time and postoperative hospital stay were 1.7 and 5.5 days, respectively. Minor prostatic capsular perforation and bladder mucosal injuries in 18 cases without need of additional interventions or treatments. Blood transfusion for preoperative anemia was needed in one case. Postoperatively, high fever occurred in 6 cases including sepsis in one case, while recatheterization was needed in 2 cases because of urination difficulty. After discharge, meatal stenosis was found in 7 cases, urethral stenosis in 3 cases including 2 cases with preoperative urethral stenosis. Scrotal abscess developed after acute epididymitis in one case. Transient urinary incontinence reported in 12 cases, which requires medication or more than 1 pad per day. HoLEP improved international prostate symptom score, quality of life score, peak urinary flow rates and postvoiding residual urine volumes immediately and significantly. HoLEP is a feasible and effective procedure to relieve lower urinary tract symptoms, although technical and instrumental advances are required to reduce the operative time and complications.

Aged↗
PubMed1998

The mechanism of successful colposuspension in genuine stress incontinence.

BACKGROUND: Colposuspension (Burch procedure) is one of the most effective surgical procedures for the cure of genuine stress incontinence in women. The aim of the current study was to understand the mechanism of successful colposuspension for treatment of this condition. METHODS: Thirty-five patients with primary genuine stress incontinence underwent colposuspension. Preoperative investigation included detailed history taking, urinalysis, pelvic floor relaxation assessments, one-hour pad test, Q-tip test, urodynamic study and perineal ultrasound urethrocystography. Follow-up results were estimated after one year. RESULTS: Twenty-five (71.4%) patients were completely cured; four (11.4%) patients showed significant improvement and six (17.1%) had recurrence of incontinence. The overall success rate was 82.9%. The complication rate was 20%. Urodynamic data revealed a significant increase in the maximal stress urethral closure pressure and proximal urethral transmission ratios. Perineal ultrasound urethrocystography and Q-tip test revealed a significant anatomic correction in bladder neck descent. CONCLUSIONS: This study confirmed that surgical cure of urinary incontinence can be achieved by restoration of the vesical neck from a dependent position in the pelvis to a position high behind the symphysis pubis, with subsequent improved pressure transmission ratios.

Adult↗
PubMed2005

Alternative uses of dextranomer/hyaluronic acid copolymer: the efficacy of bladder neck injection for urinary incontinence.

PURPOSE: Urinary continence in children with neuropathic bladder and other urological disorders depends on a bladder with adequate low pressure storage capacity and a competent outlet. Various procedures are performed with the goal of achieving continence in these patients. Recently, dextranomer/hyaluronic acid copolymer (Dx/H) has been introduced for the correction of vesicoureteral reflux. We evaluated the efficacy of submucosal bladder neck (BN) injection of Dx/H for urethral incontinence in children. MATERIALS AND METHODS: We retrospectively reviewed continence status after Dx/H injection into the BN for incontinence. Parameters examined include gender, underlying disease, prior BN surgery and means of emptying the bladder. Continence was described by the patients and/or their parents as unchanged (no change in requirements for diapers or pads), improved (longer dry intervals or requiring fewer pads/diapers) or dry (requiring no pads and dry in underwear). RESULTS: A total of 6 males and 10 females underwent injections for treatment of incontinence. Mean followup was 9.5 months (range 3 to 24). Volumes injected ranged from 0.8 to 4.4 ml (mean 1.88). Of the patients 3 achieved dryness after injection, all of whom had catheterizable urinary stomas and two-thirds had undergone bladder augmentations. All 5 patients who improved had undergone augmentation and had catheterizable channels. No improvement was seen in 8 patients. CONCLUSIONS: Injection at the BN is well tolerated and relatively easy to perform. Success rates may be better in females and in patients with neuropathic incontinence. Despite limited success it remains an option for all patients who are poor surgical candidates and those who want to avoid extensive BN reconstruction.

Adolescent↗