FURTHER EXPERIENCE WITH THE PERIURETHRAL EXPANDER - A NEW-TYPE OF ARTIFICIAL SPHINCTER

Objective To determine the long-term effects of the periurethral expan der, a new device for the treatment of urinary incontinence in childre n. Patients and methods Twenty-five patients (mean age 11.2 years, ran ge 3-22) had a periurethral expander implanted around the bladder neck within the last 41 months. Twelve of these patients had neurogenic bl adders as a result of myelomeningocele, 12 had undergone unsuccessful exstrophy reconstructions and one had megalourethra. Bladder augmentat ions 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 an d/or infection; patients with exstrophy were more susceptible to compl ications. Patients with neurogenic bladders use clean intermittent cat heterization and the remainder void spontaneously. The mean pressure i n the cuff was 58.7 cmH(2)O. Conclusion The periurethral expander seem s to be a valid option in the treatment of selected cases of urinary i ncontinence in children and young adults. There were more complication s in patients with exstrophy/epispadias and such patients must be cons idered unsuitable for this treatment.