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INTRODUCTION AND OBJECTIVES:Urinary retention is a significant adverse event after surgery which predisposes patients to increased hospital stay and avoidable returns to the Emergency Department. T...

Menkes’ syndrome, a rare sex-linked disorder of copper metabolism, has been found to be associated with a high incidence of urologic abnormalities. Bladder diverticula were present in 3 of the 4 patients reviewed. Management of incomplete bladder emptying and consequent urinary tract infection is discussed.

In most recent series of artificial sphincter implantations there has been a reduction in mechanical and surgical complications, with continence rates approaching 90 per cent. Despite initially excellent results in 47 children, with increasing durations of followup we noted a transient hydronephrosis related to incomplete bladder emptying in 5 and a persistent physiological alteration of detrusor dynamics consisting of a rigid, noncompliant bladder in 7. Preoperatively, all patients had had in-depth radiological studies and most had a urodynamic evaluation, and were considered to be excellent candidates. The etiology of these alterations is not understood at this time. Bladder and even upper tract deterioration can occur without the appearance of urinary leakage. Therefore, children with an artificial sphincter must be monitored indefinitely with semiannual assessment of the upper tracts and periodic urodynamic evaluation.