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The artificial sphincter for urinary continence
Insights
Artificial urinary sphincters effectively treat urinary incontinence in children, with most achieving daytime and nighttime dryness. Some require clean intermittent catheterization for bladder emptying, and device erosion is a rare complication.
Area of Science:
- Pediatric Urology
- Biomedical Engineering
- Device-Assisted Therapy
Background:
- Urinary incontinence in children presents significant challenges.
- Artificial urinary sphincters offer a potential solution for refractory cases.
- Assessing long-term efficacy and safety in pediatric populations is crucial.
Purpose of the Study:
- To evaluate the effectiveness and safety of artificial urinary sphincters in treating pediatric urinary incontinence.
- To assess continence rates, bladder emptying capabilities, and device-related complications.
- To determine the impact of somatic growth on device function in children.
Main Methods:
- Implantation of artificial urinary sphincters in 30 incontinent children aged 4-17 years.
- Follow-up assessments ranging from 3 months to 4 years.
- Evaluation of daytime/nighttime continence, bladder voiding, and need for clean intermittent catheterization.
Main Results:
- 28 out of 30 children achieved significant daytime and nighttime continence.
- 18 children demonstrated complete bladder emptying; 10 required clean intermittent catheterization.
- No device revisions were necessary due to somatic growth; two devices were removed due to erosion.
Conclusions:
- Artificial urinary sphincters demonstrate high efficacy in managing pediatric urinary incontinence.
- The devices are generally safe and well-tolerated, with minimal impact from somatic growth.
- Clean intermittent catheterization may be necessary for complete bladder emptying in some pediatric patients.
Abstract:
Artificial urinary sphincters were implanted in 30 incontinent children between four and 17 years of age. At follow-up for periods from three months to four years, 28 children are continent for at least three hours during the day and are dry at night. Two have had the device removed because of erosion and are still incontinent. 18 children empty their bladders completely, but 10 require clean intermittent catheterization to do so. None of the children has required revision of the device because of somatic growth.