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Related Experiment Videos

Experience with non-cycled artificial urinary sphincters.

C D A Herndon1, R C Rink, M B K Shaw

  • 1James Whitcomb Riley Hospital for Children, Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA.

BJU International
|May 15, 2004
PubMed
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Artificial urinary sphincter (AUS) implantation in children and adolescents is highly effective for achieving continence. Our study shows no cuff erosion in non-cycled AUS patients, challenging previous concerns.

Area of Science:

  • Pediatric Urology
  • Urologic Devices
  • Continence Management

Background:

  • Artificial urinary sphincter (AUS) use in pediatric patients can necessitate clean intermittent catheterization (CIC).
  • Concerns exist regarding potential ischemia with non-cycled AUS in adults, prompting investigation in pediatric populations.

Purpose of the Study:

  • To evaluate the safety and efficacy of a non-cycled artificial urinary sphincter (AUS) in children and adolescents.
  • To assess the incidence of complications, particularly cuff erosion, in a cohort of pediatric AUS patients who did not routinely cycle their devices.

Main Methods:

  • Retrospective review of 143 patients with AUS implanted between 1980 and 2002.
  • Focused analysis on 15 patients (10 boys, 5 girls) who did not routinely cycle their AUS, with a mean follow-up of 10.4 years.

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Main Results:

  • All 15 patients achieved complete continence, including six with non-functioning AUS devices.
  • No instances of cuff erosion were observed in any of the 15 patients with a non-cycled AUS.
  • Eight patients experienced mechanical complications, with most remaining dry after repair or without repair.

Conclusions:

  • The artificial urinary sphincter (AUS) is a reliable and versatile solution for achieving continence in pediatric and young adult populations.
  • Routine cycling of the AUS may not be necessary to prevent cuff erosion, contrary to some previous reports.
  • The AUS can be effectively combined with alternative catheterization methods, offering flexibility in managing bladder emptying.