INTRODUCTION

Urinary incontinence is a common sequel in patients operated on for some pathology of the extrophy-wpispadias complex.

We present our experience in the use of antegrade injection of bulking materials in the bladder neck in three patients of this type.

MATERIAL AND METHODS

We present the case of three patients with pathology of the extrophy-epipadias complex. Their ages were 5, 7 and 14 years old.

One patient had bladder exstrophy and two patients had complete epispadias.

A cervicourethroplasty was performed in all patients and ssubsequently retrograde injection of bulking material in the bladder neck due to urinary incontinence.

Despite all treatments, the patients remained incontinent.

In all cases we perform an anterograde inyection of bulking material.

To do this, we performed a suprapubic puncture with abocath, guidewire introduction, and subsequently dilation of the path to place the 5-mm Hasson trocar. The cystoscope is inserted through it, injecting the bulking material in quadrants.

RESULTS

Operative time was 40 minutes (35-50).

Hospitalization time was 24 hours. Bladder catheter time was 4 days.

Good analgesic control in all cases. No intra or postoperative complications.

Significant symptoms improvement (occasional urinary leakage in one patient).

Two-year median follow-up

CONCLUSIONS

Antegrade injection of fillers is a minimally invasive and easily reproducible technique when conventional surgery fails.

It significantly reduces the symptoms of urinary incontinence.

It improves visions of the bladder neck compared to other retrograde injection technique.

Little comorbidity and well tolerated. It presents good results in our small series of patients.