The use of small intestinal submucosa as an off-the-shelf urethral sling material for pediatric urinary incontinence

James R. Colvert*, Bradley P. Kropp, Earl Y. Cheng, John C. Pope IV, John W. Brock, Mark C. Adams, Paul Austin, Peter D. Furness, Martin A. Koyle, Marc Cendron, Antoine Khoury, Moneer Hanna, Mark Cain

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

42 Scopus citations

Abstract

Purpose: Use of autologous rectus fascia for urethral slings in the pediatric population has produced reliable and predictable results. However, the potential morbidity and complications associated with harvesting the autologous rectus fascia have driven efforts to find a reliable off-the-shelf material for urethral slings. Small intestinal submucosa is a collagen based material that has been shown to promote tissue specific regeneration in a variety of organs. We report the clinical experience at 4 institutions with small intestinal submucosa for urethral slings. Materials and Methods: A total of 20 patients 3 to 18 years old (mean age 8.7) received urethral slings using the commercially available form of small intestinal submucosa (STRATASIS, Cook Urologic Spencer, Indiana) via a sling suspension procedure from a suprapubic approach. Results: The material was consistently uniform to work with and user-friendly. All 20 patients tolerated the procedure well with no intraoperative complications. Postoperative followup has ranged from 9 to 26 months (mean 13), and 14 (70%) patients are completely dry (85% in females and 43% in males). Of the 14 dry patients 13 are on intermittent catheterization and 1 female with epispadias voids spontaneously. Conclusions: This report is the largest and longest followup series using small intestinal submucosa as an "off the shelf' urethral sling material in children. These continence rates are equal to autologous fascia without additional morbidity of graft harvest.

Original languageEnglish (US)
Pages (from-to)1872-1876
Number of pages5
JournalJournal of Urology
Volume168
Issue number4 II
StatePublished - Oct 1 2002

Keywords

  • Bladder, neurogenic
  • Bladder, urinary incontinence

ASJC Scopus subject areas

  • Urology

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