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Ten-year experience with the artificial urinary sphincter in children
P E Levesque1, S B Bauer, A Atala
1Division of Urology, Children's Hospital, Boston, Massachusetts, USA.
The Journal of Urology
|August 1, 1996
Summary
The artificial urinary sphincter offers durable, long-term solutions for pediatric incontinence, demonstrating sustained efficacy and patient continence over a decade post-implantation. Long-term monitoring is crucial due to potential renal complications.
Area of Science:
- Pediatric Urology
- Medical Device Technology
- Urological Surgery
Background:
- Intractable incontinence in children poses significant challenges.
- The artificial urinary sphincter (AUS) has been used to manage urinary incontinence.
- Long-term efficacy and survival data for AUS in pediatric populations require further evaluation.
Purpose of the Study:
- To assess the long-term efficacy and survival of the artificial urinary sphincter (AUS) in pediatric patients.
- To evaluate continence rates and device survival more than a decade after implantation.
- To compare outcomes between early and later cohorts of AUS implantation.
Main Methods:
- A retrospective analysis of pediatric patients who received an artificial urinary sphincter (AUS) before and after 1985.
- Comparison of device survival, functional outcomes, and complication rates between two distinct treatment periods.
- Evaluation of patient follow-up data extending over a decade for the initial cohort.
Main Results:
- Artificial urinary sphincter (AUS) survival rates remained consistent across both treatment groups.
- 82% of patients with functioning devices achieved dryness, indicating successful continence.
- While augmentation cystoplasty rates increased in the later series, renal failure occurred in 6 patients across both groups.
Conclusions:
- The artificial urinary sphincter (AUS) provides a durable, long-term solution for intractable pediatric incontinence.
- Long-term surveillance of the urinary tract is essential due to the risk of renal failure in patients with bladder hypertonicity.
- The study highlights the sustained effectiveness of AUS in improving quality of life for children with severe urinary incontinence.