Concomitant bladder neck closure and Mitrofanoff diversion for the management of intractable XXXX .

@entity1 @entity322 @entity3226 @entity1494 @entity3041 @entity130
In a 7-year period 28 @entity1 1 to 20 years old have undergone bladder neck closure in conjunction with Mitrofanoff diversion for the management of severe @entity322 . Surgery was performed as a salvage procedure in 19 @entity1 and as a primary anti- @entity322 procedure in 9. At a mean followup of 29 months 27 of 28 @entity1 (96%) were totally continent, requiring no pads. Bladder neck closure was primarily successful in 24 of 28 @entity1 (86%) and 25 (89%) had stable upper tracts. Five @entity1 had @entity3226 and 5 required stomal revisions. One @entity1 had a @entity1494 associated with @entity130 . Bladder neck closure and Mitrofanoff diversion were done without bladder augmentation in 11 cases and augmentation was performed previously or concurrently in the remainder. Four @entity1 who did not initially undergo augmentation required later augmentation (2 for @entity3041 and 2 for persistent @entity322 ). We conclude that bladder neck closure in conjunction with Mitrofanoff diversion is highly efficacious in achieving continence in a highly complex subgroup of @entity1 with intractable urinary leakage. With careful @entity1 selection and diligent followup total continence can be achieved in this most difficult @entity1 population.
