[Long-term follow-up of children with neurogenic bladder and artificial urinary sphincter].
METHODS
Since 1986 an artificial urinary sphincter was implanted in 16 children (13 males and 3 females) 4 to 12 years old (median age 9) in order to solve their urinary incontinence. Mean age at implantation was 9 years. In 10 children (63%) only the implant procedure of artificial sphincter was performed without any other procedure associated (Group A), while in 6 children an augmentation cystoplasty simultaneously was performed (Group B). The results were analysed in both groups separately: 1. Group A: 10 patients. Two are functioning excellently after 10 and 11 years of follow up. Eight developed some type of troublesome: Five developed a deterioration of urinary tract and all of five were treated by augmentation cystoplasty; one of them is in a good condition after 11 years, another presented a fail of the device after 10 years, it has been changed, and in the others three the apparatus was removed by diverse causes. Two developed a mechanical fail of device: one was removed due familiar decision and the other has received another device. One urinary fistula developed 6 months later. The device was removed. 2. Group B: 6 patients (artificial sphincter and augmentation cystoplasty simultaneously). Five are functioning without trouble some. One persistent urinary fistula. The device was removed. Actually, of 16 cases (both groups) 8 cases (50%) are good functioning, 6 devices have been removed and 2 are waiting a new implant.


CONCLUSIONS
The artificial urinary sphincter is a good solution for children with urinary incontinence in selected cases, but is mandatory a correct follow up because longterm complications can be developed. Results seem better when an augmentation cystoplasty is associated.
Miguélez Lago
C
C
Hospital Materno-Infantil de Málaga.
Galiano Duro
E
E
García Mérida
M
M
D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D012086:Reoperation; D013997:Time Factors; D001743:Urinary Bladder / Q000601:surgery; D001747:Urinary Bladder Fistula / Q000209:etiology; D001750:Urinary Bladder, Neurogenic / Q000601:surgery*; D014549:Urinary Incontinence / Q000517:prevention & control*; D016741:Urinary Sphincter, Artificial