Artificial sphincters in children with neurogenic bladders: long-term results.

Inflatable bladder sphincters (models AS 721 and AS 792) were implanted in 10 boys and 5 girls, between 5 and 17 years old, who had neurogenic bladders without residual urine or reflux and with normal renal function. Of the boys 9 are continent with an average followup of 51.5 months, whereas only 1 of the girls is continent. The incidence of mechanical failures is lower with the new AS 792 sphincter (2 of 11 versus 7 of 13 devices), and the 2 erosions occurred in girls whose bladder necks were opened during implantation. The artificial sphincter is useful in boys with neurogenic bladders without residual urine if bladder spasticity is controlled. We use the device in girls only when pharmacological methods and intermittent catheterization have failed. We have been satisfied with the long-term results even if reoperations were needed.