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Ten-Year Experience with the Artificial Urianary Sphincter in Children

1996; Lippincott Williams & Wilkins; Volume: 156; Issue: 2S Linguagem: Inglês

10.1016/s0022-5347(01)65767-7

1527-3792

Peter E. Levesque, Stuart B. Bauer, Anthony Atala, David Zurakowski, Arnold H. Colodny, Craig A. Peters, Alan B. Retik,

Bladder and Urothelial Cancer Treatments

No AccessJournal of UrologyIncontinence1 Aug 1996Ten-Year Experience with the Artificial Urianary Sphincter in Children Peter E. Levesque, Stuart B. Bauer, Anthony Atala, David Zurakowski, Arnold Colodny, Craig Peters, and Alan B. Retik Peter E. LevesquePeter E. Levesque , Stuart B. BauerStuart B. Bauer , Anthony AtalaAnthony Atala , David ZurakowskiDavid Zurakowski , Arnold ColodnyArnold Colodny , Craig PetersCraig Peters , and Alan B. RetikAlan B. Retik View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)65767-7AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: To assess the efficacy of the artificial urinary sphincter survival and continence were first evaluated 5 years ago. We now evaluated the effects of the artificial urinary sphincter more than a decade after implantation. Materials and Methods: Before 1985 an artificial urinary sphincter was implanted in 22 male and 14 female consecutive patients 4 to 30 years old (median age 12). In addition, between 1985 and 1990, 18 other children underwent artificial urinary sphincter implantation. Results of both series were compared. Results: Of the 25 sphincters in the original series that were functioning after 5 years 1 was removed and 2 patients were lost to followup, resulting in 22 functioning implants (61 percent of the patients). Mean survival time of the prostheses was 12.1 years and average followup for functioning sphincters was 13.7 years. There was no statistically significant difference in artificial urinary sphincter survival between the original group at 5 years and the second group treated after 1985. Of the patients in both groups with sphincters in place 32 of 39 (82 percent) were dry. Augmentation cystoplasty was performed in 9 of 18 patients (50 percent) in the second series (5 preoperatively and 4 postoperatively) compared to 10 of 36 (28 percent) in the original series at 5 years (3 preoperatively and 7 postoperatively). Renal failure developed in 6 patients from both series. Conclusions: The artificial urinary sphincter is a durable long-term solution for children with intractable incontinence. Long-term surveillance of the urinary tract is mandatory because of the potential for renal failure in patients who have bladder hypertonicity after placement of the device. References 1 : Modified pubovaginal sling in girls with myelodysplasia. J. Urol.1986; 135: 94. Link, Google Scholar 2 : Fascial sling to correct male neurogenic sphincter incompetence: the McGuire/Raz approach. J. Urol.1988; 139: 528. Link, Google Scholar 3 : Treatment of urinary incontinence by periurethral implantation of glutaraldehyde cross-linked collagen. J. Urol.1989; 141: 538. 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Google Scholar From the Division of Urology, Children's Hospital, Boston, Massachusetts.© 1996 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byViers B, Elliott D and Kramer S (2013) Simultaneous Augmentation Cystoplasty and Cuff Only Artificial Urinary Sphincter in Children and Young Adults with Neurogenic Urinary IncontinenceJournal of Urology, VOL. 191, NO. 4, (1104-1109), Online publication date: 1-Apr-2014.Bar-Yosef Y, Castellan M, Joshi D, Labbie A and Gosalbez R (2011) Total Continence Reconstruction Using the Artificial Urinary Sphincter and the Malone Antegrade Continence EnemaJournal of Urology, VOL. 185, NO. 4, (1444-1448), Online publication date: 1-Apr-2011.Churchill B, Bergman J, Kristo B and Gore J (2010) Improved Continence in Patients With Neurogenic Sphincteric Incompetence With Combination Tubularized Posterior Urethroplasty and Fascial Wrap: The Lengthening, Narrowing and Tightening ProcedureJournal of Urology, VOL. 184, NO. 4S, (1763-1767), Online publication date: 1-Oct-2010.Dean G and Kunkle D (2009) Outpatient Perineal Sling in Adolescent Boys With Neurogenic IncontinenceJournal of Urology, VOL. 182, NO. 4S, (1792-1796), Online publication date: 1-Oct-2009.Catti M, Lortat-Jacob S, Morineau M and Lottmann H (2008) Artificial Urinary Sphincter in Children—Voiding or Emptying? 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Volume 156Issue 2SAugust 1996Page: 625-628 Advertisement Copyright & Permissions© 1996 by American Urological Association, Inc.MetricsAuthor Information Peter E. Levesque More articles by this author Stuart B. Bauer More articles by this author Anthony Atala More articles by this author David Zurakowski More articles by this author Arnold Colodny More articles by this author Craig Peters More articles by this author Alan B. Retik More articles by this author Expand All Advertisement PDF downloadLoading ...