A clinical experience with the Scott genitourinary sphincter in the management of urinary incontinence in the pediatric age group.

We report our experience with 22 Scott genitourinary sphincters implanted in 19 patients during a period of 4 years. Patient selection was rigid. Incontinence must be unremitting and fail to respond to exhaustive efforts at control by pharmacologic manipulation with or without intermittent catheterization. The patient must be able to empty the bladder by Credé's or Valsalva's maneuver, and consider the incontinence intolerable. The artificial sphincter is considered as an alternative to urinary diversion. A second attempt at placement has been done in 3 patients. Removal was required in 32 per cent of the devices. However, 79 per cent of the patients did achieve our goal of continence. Therefore, we have found the artificial sphincter to be a valuable addition to the treatment of pediatric incontinence as an alternative to urinary diversion.