ORIGINAL RESEARCH

The use of synthetic slings in surgical treatment of epispadias in boys

Demidov AA
About authors

Scientific Research Institute of Pediatric Surgery,
Pirogov Russian National Research Medical University, Moscow, Russia

Correspondence should be addressed: Alexander Demidov
Shmitovskiy pr-d, d. 29, str. 3, Moscow, Russia, 123317; ur.tsil@01lavodimed

Received: 2016-10-12 Accepted: 2016-10-21 Published online: 2017-01-05
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The treatment of urinary incontinence in epispadias, which is malformation of the lower urinary tract, is a pressing problem due to the severity of congenital anatomic and functional pathology and the lack of a universal treatment to achieve urinary control. The aim of the study was to develop basic principles of surgical treatment of epispadias-related urinary incontinence. Additionally, we aimed to introduce into clinical practice the use of synthetic implants (synthetic slings) and evaluate treatment outcomes. The total of 20 boys aged 7–15 years received surgical treatment for subtotal and total epispadias. The first stage of surgical reconstruction was Cantwell’s phallo-urethroplasty followed by the placement of synthetic slings TVT, TVT-O, and AdVance. The children began to accumulate up to 250–550 ml of urine in any position of the body at relative rest and on effort, and were able to hold urine for up to 3 hours and to empty the bladder completely with normal flow. The total loss of urine per day decreased 10-15 times and did not exceed 10–30 ml. The lower urinary tract was evaluated using urodynamic (uroflowmetry, urethral profilometry) and electrophysiological (electroneuromyography) methods. Restoration of urethral anatomy leads to improved accumulative ability of the detrusor, and use of synthetic slings is a low-invasive and highly effective surgical method for treating urinary incontinence.

Keywords: implant, epispadias, boy, urethroplasty, sling

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