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Use of the AS800 device in exstrophy and epispadias
R M Decter1, D R Roth, I J Fishman
1Scott Department of Urology, Baylor College of Medicine, Houston, Texas.
The Journal of Urology
|November 1, 1988
Summary
The artificial genitourinary sphincter (AGS) effectively manages urinary incontinence in patients with bladder exstrophy and epispadias, even after prior surgeries. This device offers a viable solution for achieving continence in challenging cases.
Area of Science:
- Urology
- Pediatric Surgery
- Reconstructive Surgery
Background:
- Achieving urinary continence is a significant challenge for patients with bladder exstrophy and epispadias.
- While bladder neck reconstruction can yield good results, data on repeat procedures are limited.
- The artificial genitourinary sphincter (AGS) presents an alternative management strategy.
Purpose of the Study:
- To evaluate the efficacy of the AS800 artificial genitourinary sphincter in patients with exstrophy and epispadias.
- To assess continence success rates in a cohort, including those with prior bladder neck operations.
Main Methods:
- The AS800 device was implanted in 16 patients diagnosed with exstrophy or epispadias.
- Thirteen of these patients had a history of at least one previous bladder neck reconstruction.
- Outcomes were assessed based on total success and continence success rates.
Main Results:
- An overall success rate of 69% (excluding patients awaiting revision) was achieved.
- A continence success rate of 90% (for patients with an active device) was reported.
- Significant rates of revision and erosion were noted, but the final outcomes were satisfactory.
Conclusions:
- The AS800 artificial genitourinary sphincter is a valuable option for managing urinary incontinence in complex exstrophy and epispadias cases.
- Despite challenges like revision and erosion, the device provides satisfactory long-term continence in this difficult patient population.