Bladder Neck Closure (BNC) is a rarely performed procedure for intractable urinary incontinence. Two main approaches, transabdominal and transvaginal, are described. In this paper, we assess the outcomes of these two different techniques.

We reviewed the outcomes of 25 consecutive patients who had BNC performed in one unit for intractable urinary incontinence. Data assessed were patient demographics, underlying diagnosis, technique of BNC, the use and type of tissue interposition and whether concurrent bladder augmentation or urinary diversion was performed. Statistical analysis was by Chi Squared Test and significance determined as P < 0.05.

Results are shown on table 1. 18 Patients had bladder neck closure via a transabdominal approach, and 7 had a vaginal one with a success rate of 83% and 71% respectively at first attempt. In total 4 patients had revision surgery and they were all successful.

From our results we can see how the use of tissue interposition correlated with a successful outcome in 91% of patients at first surgical attempt.  When a previous history of radiotherapy treatment was present the success rate fell at 33%. Results are shown in Table 1.

Bladder neck closure is a valid surgical option in patients with intractable urinary incontinence. History of radiotherapy and lack of tissue interposition were significantly associated with failure of BNC whilst route of repair did not.