Experience with non-cycled artificial urinary sphincters

C. D A Herndon, R. C. Rink, M. B K Shaw, M. P. Cain, Anthony J. Casale

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

OBJECTIVE: To report our experience in children and adolescents with a non-cycled artificial urinary sphincter. While some children with the AUS can void, others require clean intermittent catheterization (CIC) through the sphincter or an alternative site for catheterization; in some of the latter we have either not cycled (pumped) an activated AUS or the AUS has failed, and there is concern about ischaemia in some adults with a non-cycled AUS. PATIENTS AND METHODS: In all, 143 patients who had an AUS placed between 1980 and 2002 were reviewed retrospectively; 15 (10 boys and five girls) no longer cycled (pumped) their AUS. The mean age at AUS insertion was 11 years and the mean (range) follow-up after insertion was 10.4 (1.64-22.2) years. The diagnoses included myelomeningocele in 11, sacral agenesis in three and cloaca in one. Nine patients have an activated functioning AUS and in six the AUS does not function; in the first nine the sphincter has not routinely been cycled (pumped) for a mean (range) of 1.6 (0.6-2.9) years. In the other six with a nonfunctioning AUS the mean (range) observation period is 6.4 (1.5-10) years since the system has not functioned. RESULTS: All patients were completely continent, including the six with a nonfunctioning AUS. After inserting the AUS, two patients voided in combination with CIC (one each urethral and abdominal stoma) and 13 emptied by CIC (nine abdominal stoma, four urethral). There was a mechanical complication in eight patients; three had the AUS repaired and are dry, and five are dry with no repair. In one patient the AUS was never activated. To date there has been no erosion of the cuff in any of the 15 patients with a non-cycled AUS. CONCLUSION: The AUS remains an extremely reliable procedure to achieve continence in children and young adults. It is versatile and can be combined with other procedures that provide an alternative means for catheterization. While some have noted the need to routinely cycle the AUS to prevent erosion, this has not been our experience in these 15 patients.

Original languageEnglish (US)
Pages (from-to)1049-1052
Number of pages4
JournalBJU International
Volume93
Issue number7
DOIs
StatePublished - May 2004
Externally publishedYes

Fingerprint

Artificial Urinary Sphincter
Intermittent Urethral Catheterization
Catheterization
Cloaca
Meningomyelocele
Young Adult
Ischemia
Observation

Keywords

  • Artificial urinary sphincter
  • Children
  • Incontinence
  • Outcome

ASJC Scopus subject areas

  • Urology

Cite this

Experience with non-cycled artificial urinary sphincters. / Herndon, C. D A; Rink, R. C.; Shaw, M. B K; Cain, M. P.; Casale, Anthony J.

In: BJU International, Vol. 93, No. 7, 05.2004, p. 1049-1052.

Research output: Contribution to journalArticle

Herndon, C. D A ; Rink, R. C. ; Shaw, M. B K ; Cain, M. P. ; Casale, Anthony J. / Experience with non-cycled artificial urinary sphincters. In: BJU International. 2004 ; Vol. 93, No. 7. pp. 1049-1052.
@article{18c16ac805ec43f6b835727272b7271b,
title = "Experience with non-cycled artificial urinary sphincters",
abstract = "OBJECTIVE: To report our experience in children and adolescents with a non-cycled artificial urinary sphincter. While some children with the AUS can void, others require clean intermittent catheterization (CIC) through the sphincter or an alternative site for catheterization; in some of the latter we have either not cycled (pumped) an activated AUS or the AUS has failed, and there is concern about ischaemia in some adults with a non-cycled AUS. PATIENTS AND METHODS: In all, 143 patients who had an AUS placed between 1980 and 2002 were reviewed retrospectively; 15 (10 boys and five girls) no longer cycled (pumped) their AUS. The mean age at AUS insertion was 11 years and the mean (range) follow-up after insertion was 10.4 (1.64-22.2) years. The diagnoses included myelomeningocele in 11, sacral agenesis in three and cloaca in one. Nine patients have an activated functioning AUS and in six the AUS does not function; in the first nine the sphincter has not routinely been cycled (pumped) for a mean (range) of 1.6 (0.6-2.9) years. In the other six with a nonfunctioning AUS the mean (range) observation period is 6.4 (1.5-10) years since the system has not functioned. RESULTS: All patients were completely continent, including the six with a nonfunctioning AUS. After inserting the AUS, two patients voided in combination with CIC (one each urethral and abdominal stoma) and 13 emptied by CIC (nine abdominal stoma, four urethral). There was a mechanical complication in eight patients; three had the AUS repaired and are dry, and five are dry with no repair. In one patient the AUS was never activated. To date there has been no erosion of the cuff in any of the 15 patients with a non-cycled AUS. CONCLUSION: The AUS remains an extremely reliable procedure to achieve continence in children and young adults. It is versatile and can be combined with other procedures that provide an alternative means for catheterization. While some have noted the need to routinely cycle the AUS to prevent erosion, this has not been our experience in these 15 patients.",
keywords = "Artificial urinary sphincter, Children, Incontinence, Outcome",
author = "Herndon, {C. D A} and Rink, {R. C.} and Shaw, {M. B K} and Cain, {M. P.} and Casale, {Anthony J.}",
year = "2004",
month = "5",
doi = "10.1111/j.1464-410X.2003.04779.x",
language = "English (US)",
volume = "93",
pages = "1049--1052",
journal = "BJU International",
issn = "1464-4096",
publisher = "Wiley-Blackwell",
number = "7",

}

TY - JOUR

T1 - Experience with non-cycled artificial urinary sphincters

AU - Herndon, C. D A

AU - Rink, R. C.

AU - Shaw, M. B K

AU - Cain, M. P.

AU - Casale, Anthony J.

PY - 2004/5

Y1 - 2004/5

N2 - OBJECTIVE: To report our experience in children and adolescents with a non-cycled artificial urinary sphincter. While some children with the AUS can void, others require clean intermittent catheterization (CIC) through the sphincter or an alternative site for catheterization; in some of the latter we have either not cycled (pumped) an activated AUS or the AUS has failed, and there is concern about ischaemia in some adults with a non-cycled AUS. PATIENTS AND METHODS: In all, 143 patients who had an AUS placed between 1980 and 2002 were reviewed retrospectively; 15 (10 boys and five girls) no longer cycled (pumped) their AUS. The mean age at AUS insertion was 11 years and the mean (range) follow-up after insertion was 10.4 (1.64-22.2) years. The diagnoses included myelomeningocele in 11, sacral agenesis in three and cloaca in one. Nine patients have an activated functioning AUS and in six the AUS does not function; in the first nine the sphincter has not routinely been cycled (pumped) for a mean (range) of 1.6 (0.6-2.9) years. In the other six with a nonfunctioning AUS the mean (range) observation period is 6.4 (1.5-10) years since the system has not functioned. RESULTS: All patients were completely continent, including the six with a nonfunctioning AUS. After inserting the AUS, two patients voided in combination with CIC (one each urethral and abdominal stoma) and 13 emptied by CIC (nine abdominal stoma, four urethral). There was a mechanical complication in eight patients; three had the AUS repaired and are dry, and five are dry with no repair. In one patient the AUS was never activated. To date there has been no erosion of the cuff in any of the 15 patients with a non-cycled AUS. CONCLUSION: The AUS remains an extremely reliable procedure to achieve continence in children and young adults. It is versatile and can be combined with other procedures that provide an alternative means for catheterization. While some have noted the need to routinely cycle the AUS to prevent erosion, this has not been our experience in these 15 patients.

AB - OBJECTIVE: To report our experience in children and adolescents with a non-cycled artificial urinary sphincter. While some children with the AUS can void, others require clean intermittent catheterization (CIC) through the sphincter or an alternative site for catheterization; in some of the latter we have either not cycled (pumped) an activated AUS or the AUS has failed, and there is concern about ischaemia in some adults with a non-cycled AUS. PATIENTS AND METHODS: In all, 143 patients who had an AUS placed between 1980 and 2002 were reviewed retrospectively; 15 (10 boys and five girls) no longer cycled (pumped) their AUS. The mean age at AUS insertion was 11 years and the mean (range) follow-up after insertion was 10.4 (1.64-22.2) years. The diagnoses included myelomeningocele in 11, sacral agenesis in three and cloaca in one. Nine patients have an activated functioning AUS and in six the AUS does not function; in the first nine the sphincter has not routinely been cycled (pumped) for a mean (range) of 1.6 (0.6-2.9) years. In the other six with a nonfunctioning AUS the mean (range) observation period is 6.4 (1.5-10) years since the system has not functioned. RESULTS: All patients were completely continent, including the six with a nonfunctioning AUS. After inserting the AUS, two patients voided in combination with CIC (one each urethral and abdominal stoma) and 13 emptied by CIC (nine abdominal stoma, four urethral). There was a mechanical complication in eight patients; three had the AUS repaired and are dry, and five are dry with no repair. In one patient the AUS was never activated. To date there has been no erosion of the cuff in any of the 15 patients with a non-cycled AUS. CONCLUSION: The AUS remains an extremely reliable procedure to achieve continence in children and young adults. It is versatile and can be combined with other procedures that provide an alternative means for catheterization. While some have noted the need to routinely cycle the AUS to prevent erosion, this has not been our experience in these 15 patients.

KW - Artificial urinary sphincter

KW - Children

KW - Incontinence

KW - Outcome

UR - http://www.scopus.com/inward/record.url?scp=2542631919&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=2542631919&partnerID=8YFLogxK

U2 - 10.1111/j.1464-410X.2003.04779.x

DO - 10.1111/j.1464-410X.2003.04779.x

M3 - Article

VL - 93

SP - 1049

EP - 1052

JO - BJU International

JF - BJU International

SN - 1464-4096

IS - 7

ER -