Treatment of Persistent Urinary Incontinence in Children

Inclusion Criteria: Urologic Inclusion Criteria: * Primary or secondary daytime urinary incontinence, persistent over 12 months of medical treatment * An abnormal 3 day voiding diary compiled over a 3 week voiding period completed after 12 months of medical treatment * Normal bladder ultrasound (if bladder ultrasound shows more than minimal bladder thickening \[\>3.0mm at 50% filling of expected capacity or less\] then a voiding cystourethrogram \[VCUG\] will be required to rule out bladder outlet obstruction) * Abnormal urodynamic testing Radiologic Inclusion Criteria: * Normal position conus medullaris * Any size filum terminale * Any amount of fat in the filum terminale * Terminal syringomyelia of less than one bony level is acceptable * Lumbar bifid spinal lamina is acceptable Exclusion Criteria: * Patients with evidence of significant, progressive, lower extremity motor or sensory deficits, with evidence of progression over the previous 6 months * The presence of cutaneous markings on the back, in the absence of confirmatory magnetic resonance imaging (MRI) findings of a specific spinal dysraphism does not exclude the patient from participation