title: Further experience with the periurethral expander: a new type of artificial sphincter.
abstract: OBJECTIVE
  To determine the long-term effects of the periurethral expander, a new device for the treatment of urinary incontinence in children.
  
  
  METHODS
  Twenty-five patients (mean age 11.2 years, range 3-22) had a periurethral expander implanted around the bladder neck within the last 41 months. Twelve of these patients had neurogenic bladders as a result of myelomeningocele, 12 had undergone unsuccessful exstrophy reconstructions and one had megalourethra. Bladder augmentations were carried out in 23 of the patients. The mean follow-up was 23 months.
  
  
  RESULTS
  Ten patients had the device removed due to erosion and/or infection; patients with exstrophy were more susceptible to complications. Patients with neurogenic bladders use clean intermittent catheterization and the remainder void spontaneously. The mean pressure in the cuff was 58.7 cmH2O.
  
  
  CONCLUSIONS
  The periurethral expander seems to be a valid option in the treatment of selected cases of urinary incontinence in children and young adults. There were more complications in patients with exstrophy/epispadias and such patients must be considered unsuitable for this treatment.
authors.affiliation: Hospital das Clinicas, Federal University of Pernambuco, Recife, Brazil.
authors.forename: S V
authors.initials: SV
authors.lastname: Lima
authors.forename: L A
authors.initials: LA
authors.lastname: Araújo
authors.forename: F O
authors.initials: FO
authors.lastname: Vilar
mesh_terms: D000293:Adolescent; D000328:Adult; D001746:Bladder Exstrophy / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008591:Meningomyelocele / Q000601:surgery; D019736:Prostheses and Implants; D001750:Urinary Bladder, Neurogenic / Q000601:surgery; D014549:Urinary Incontinence / Q000601:surgery*; D016741:Urinary Sphincter, Artificial / Q000009:adverse effects