[Artificial urinary sphincter in the treatment of neurogenic bladder in children].
Over a two years period, the model AS 800 artificial urinary sphincter was implanted in 10 children (mean 14 years old) with incontinence due to a neurogenic bladder (7 spina bifida; 3 sacral agenesis). Goal of continence was achieved in 100% of 7 boys and 3 girls with a follow up between 6-32 months (mean 17 months). Patients selection was rigid and incontinence have failed to response at pharmaceutic manipulation (6) intermittent catheterisation (5) and previous classical surgery enterocystoplasty (2), Young-Dees procedure (1). Age minimum was 8 years. All sphincters were implanted around the bladder neck. Associated surgical techniques were performed in 4 cases: 2 detubularized enterocystoplasties, 1 Teflon injection for vesico ureteral reflux, 1 closure of previous cystostomy. Sphincterotomy was never done. 5 patients are submitted post implantation to intermittent catheterisation without any problem. 2 patients required one revision. Nocturnal desactivation is used in 2 cases. Authors focus on the necessity of correcting previously or at the time of implantation bladder compliance and vesico ureteral reflux.
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001187:Artificial Organs; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D011859:Radiography; D012447:Sacrum / Q000002:abnormalities; D016136:Spina Bifida Occulta / Q000150:complications; D001743:Urinary Bladder; D001750:Urinary Bladder, Neurogenic / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*
Le sphincter artificiel urinaire dans le traitement des vessies neurologiques de l'enfant.