Artificial Urinary Sphincter In Children - Voiding Or Emptying? An Evaluation Of Functional Results In 44 Patients

Main Category: Urology / Nephrology
Also Included In: Pediatrics / Children's Health
Article Date: 15 Sep 2008 - 2:00 PDT

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UroToday.com - In an article from the Journal of Urology, Dr M. Catti et al. evaluated the functional results of an artificial urinary sphincter in children and adolescents. Forty-four patients underwent implantation of an AMS 800™ urinary sphincter for severe urinary incontinence due to a neuropathic origin. Of the 44 patients, 25 had undergone augmentation cystoplasty. The patients were followed for a median of 5.5 years.

Of the 44 patients, nine (20%) were incontinent after removal of the artificial urinary sphincter due to complications. Among the remaining 35 patients who had the sphincter remain in place, 32 were dry. Of these patients, almost 50% voided to completion with spontaneous voiding. 25% performed clean intermittent catheterization after voiding, and the remaining 25.7% emptied exclusively with CIC. It was noted that the ability to void to completion after implantation was significantly decreased when the sphincter was implanted before puberty or in conjunction with an augmented bladder.

The group concluded that the urinary artificial sphincter provides a good rate of continence. They do note that complications were frequent and led to removal in about 20% of the cases. They also found that, in time, only a few patients could empty their bladders to completion without the use of intermittent catheterization. The artificial urinary sphincter seems to prove itself in the test of time. One has to remember that failures are typically seen 7-10 years out from primary placement.

Catti M, Lortat-Jacob S, Morineau M, Lottmann H
J Urol. 2008 Aug;180(2):690-3
10.1016/j.juro.2008.04.039

Written by UroToday.com Medical Editor Pasquale Casale, MD

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