Detrusor behaviour following implantation of the Brantley Scott artificial urinary sphincter for neuropathic incontinence.

During a 3-year period, 102 Brantley Scott artificial urinary sphincters were implanted to control urinary incontinence. Nineteen patients underwent endoscopic sphincterotomy and artificial sphincter implantation for the control of sphincter weakness incontinence due to congenital neuropathic bladder dysfunction. None had previous augmentation or substitution procedures. Nine patients (47%) subsequently showed a deterioration in detrusor function, resulting in either recurrent incontinence or upper tract dilatation. Eight of these (89%) had previously been shown to have an intermediate pattern of neuropathic bladder abnormality. All patients implanted with an AUS require long-term surveillance including videourodynamic studies, and patients with intermediate neuropathic bladders should be considered for augmentation or substitution at the time of implantation.