{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:58:17Z","timestamp":1760151497884,"version":"build-2065373602"},"reference-count":10,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T00:00:00Z","timestamp":1647993600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Introduction: Urinary incontinence is common in patients with neurogenic bladder, and efficient management is an ongoing challenge. Besides open surgical procedures like bladder neck reconstruction, artificial sphincter implantation, or sling procedures, endoscopic bladder neck injections of bulking agents enable minimally invasive access with promising results. Several studies report on the effect of antegrade vs. retrograde endoscopic injection techniques. We report our preliminary experience of combined antegrade and retrograde endoscopic injection of the bladder neck in children with neurogenic bladder, in selected cases combined with intravesical Botox\u00ae injection. Methods: With the patient in lithotomy position, antegrade urethrocystoscopy was performed using a 9.5 Fr cystoscope. In parallel, percutaneous suprapubic bladder access introducing a second 9.5 Fr. cystoscope was accomplished. Four quadrant Dx\/H injections were performed, with the two surgeons guiding each other by parallel endoscopy to the optimal localization for injection. In selected patients, the procedure was completed with transurethral intravesical Botox\u00ae injection. Results: A total of 6 children underwent the combined procedure (2\/6 patients including intravesical Botox\u00ae injection). The mean follow-up was 15 months (range 3 to 48). 5 Patients experienced a significant improvement of urinary incontinence, however one patient demonstrated complete failure. Conclusions: Even if we present only preliminary results with a limited number of patients, we present a minimally invasive technique with encouraging results. In carefully selected patients, combined antegrade and retrograde endoscopic injection of the bladder neck is a useful tool to treat urinary incontinence.<\/jats:p>","DOI":"10.3390\/children9040449","type":"journal-article","created":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T12:20:25Z","timestamp":1648038025000},"page":"449","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Current Concepts in Endoscopic Bladder Neck Injection: Combined Antegrade and Retrograde Endoscopic Injection of the Bladder Neck in Children with Neurogenic Bladder"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8426-5011","authenticated-orcid":false,"given":"Frank-Martin","family":"Haecker","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, Children\u2019s Hospital of Eastern Switzerland, 9006 St. Gallen, Switzerland"},{"name":"Faculty of Medicine, University of Basel, 4001 Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anja","family":"Mettler","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Children\u2019s Hospital of Eastern Switzerland, 9006 St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Mack","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Children\u2019s Hospital of Eastern Switzerland, 9006 St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/S0022-5347(17)48903-8","article-title":"Polytetrafluorethylene injection for urinary in-continence in children","volume":"133","author":"Vorstman","year":"1985","journal-title":"J. Urol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1016\/S0022-5347(01)67168-4","article-title":"A new bioimplant for the endoscopic treatment of vesicoureteral reflux: Experimental and short term clinical results","volume":"154","author":"Stenberg","year":"1995","journal-title":"J. Urol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1097\/01.ju.0000179253.13807.82","article-title":"Alternative uses of dextranomer\/hyaluronic acid copolymer: The efficacy of bladder neck injection for urinary incontinence","volume":"174 Pt 2","author":"Misseri","year":"2005","journal-title":"J. Urol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1016\/S0022-5347(05)00669-5","article-title":"Long-term effects of dextranomer endoscopic injections for treatment or urinary incontinence: An update of a prospective study of 31 patients","volume":"175","author":"Lottmann","year":"2006","journal-title":"J. Urol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1762","DOI":"10.1016\/j.juro.2006.03.121","article-title":"Long-term effects of dextranomer endoscopic injections for treatment or urinary incontinence: An update of a prospective study of 61 patients","volume":"176","author":"Lottmann","year":"2006","journal-title":"J. Urol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1628","DOI":"10.1016\/j.juro.2007.05.092","article-title":"Endoscopic injection of bulking agents in children with incontinence: Dextranomer\/hyaluronic acid copolymer versus polytetrafluoroethylene","volume":"178","author":"Dyer","year":"2007","journal-title":"J. Urol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1016\/j.juro.2007.04.005","article-title":"Antegrade and Retrograde Dextranomer\/Hyaluronic Acid Bladder Neck Bulking for Pediatric Incontinence","volume":"178","author":"Dean","year":"2007","journal-title":"J. Urol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1905","DOI":"10.1016\/j.juro.2012.07.016","article-title":"Long-term effects of endoscopic injection of dextranomer\/hyaluronic acid based implants for treatment of urinary incontinence in children with neurogenic bladder","volume":"188","author":"Alova","year":"2012","journal-title":"J. Urol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"526.e1","DOI":"10.1016\/j.jpurol.2021.05.019","article-title":"Comparison of antegrade and retrograde endoscopic injection techniques for neurogenic sphincteric incontinence in children with neurogenic bladder","volume":"17","author":"Lahlou","year":"2021","journal-title":"J. Pediatr. Urol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.jpurol.2012.03.013","article-title":"Dextranomer\/hyaluronic acid bladder neck injection for persistent outlet incompetency after sling procedures in children with neurogenic urinary incontinence","volume":"9","author":"DaJusta","year":"2013","journal-title":"J. Pediatr. Urol."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/4\/449\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:41:17Z","timestamp":1760136077000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/4\/449"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,23]]},"references-count":10,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4]]}},"alternative-id":["children9040449"],"URL":"https:\/\/doi.org\/10.3390\/children9040449","relation":{},"ISSN":["2227-9067"],"issn-type":[{"type":"electronic","value":"2227-9067"}],"subject":[],"published":{"date-parts":[[2022,3,23]]}}}