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Grimsby GM, Menon V, Schlomer BJ, Baker LA, et al. Long-term outcomes of bladder neck reconstruction without augmentation cystoplasty in children. J Urol. 2016;195:155–61. In this 109 patient retrospective series of varied bladder neck procedures followed for a mean of 4.9 years, 54% underwent secondary continence procedures, 18% proceeded to augmentation cystoplasty. Nearly half developed VUR or hydronephrosis and 21% renal scarring during the study period. No preoperative findings on urodynamics predicted the need for delayed augmentation although a history of vesicostomy or VUR were significnat associations.
Snodgrass W, Granberg C, Clinical indications for augmentation in children with neurogenic urinary incontinence following bladder outlet procedures: results of a 14-year observational study. J Pediatr Urol, 2016. published ahead of print: p. 1.e1-8. This 82 patient retrospective series demonstrated feasibility and revision of surgical techniques over time in the use of a Leadbetter/Mitchell bladder neck revision with sling as compared to later use of a bladder neck sling alone that significantly improved continence outcomes in the absence of augmentation cystoplasty. While 12% of children in this series after a mean followup of 60 months proceeded to augmentation cystoplasty, no preoperative UDS parameter predicted need for subsequent augmentation.
Whittam B, Szymanski K, Misseri R, Carroll A, Kaefer M, Rink R, et al. Long-term fate of the bladder after isolated bladder neck procedure. J Pediatr Urol. 2014;10:886–91. In this retrospective series of 29 individuals who underwent bladder neck procedrues followed for a mean of 8.9 yearss, 45% proceeded to a delayed augmentation cystoplasty. Although preoperative UDS findings did not correlate with outcomes, those who underwent delayed augment had smaller capacity bladders and poorer compliance following BNR.
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