Biological response of bladders rendered continent by insertion of artificial sphincter

Artificial sphincters were inserted in 44 children for intractable urinary incontinence. Of the patients 70 per cent achieved satisfactory continence (minimum followup 18 months) with no revisions, and 10 per cent were rendered continent with 1 revision and 10 per cent with multiple revisions. The procedure failed in 10 per cent of the patients primarily because of infection. Extensive urodynamic studies were performed at reoperation and postoperatively. Long-term urodynamic followup was available in 36 continent children. Hydronephrosis occurred in 2 per cent of the upper tracts assessed and 18 per cent of the patients had significant residual urine. Mean bladder capacity tended to increase progressively postoperatively. Mean bladder compliance also was well maintained.