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We report on the intraurethral insertion of the Memokath in 24 patients (26 stents) to combat detrusor-sphincter dyssynergia developing after spinal cord injury. Most patients have high tetraplegia for whom self-catheterisation is very difficult, if not impossible. Our results have been disappointing in that 19 stents have had to be removed, mainly because of persisting urinary infection, migration of the stent, or because of failure to improve emptying, usually associated with poor detrusor function. Caution is therefore advised in the use of this stent for detrusor-sphincter dyssynergia and it is not recommended in patients with chronic urinary infection. With better patient selection however, perhaps aided by modifications to stent design, the Memokath may still prove to be a simple and reversible alternative to sphincterotomy in this difficult group of patients.

Objective To review retrospectively the Perth experience of autotransplantation for loin pain haematuria syndrome and identify possible factors associated with its failure. Patients and methods The medical records of 11 women patients (median age 42 years, range 29–48) who had 12 autotransplantations were reviewed. All patients were then interviewed and asked whether they considered the operation a success. Results All patients initally had complete relief of symptoms. Three patients who had four transplants are still symptom‐free with a follow‐up of 24–46 months. Five patients have had partial relief with marked variability in their patterns of recurrent pain. Three patient have symptoms as severe as those before operation. One kidney was lost because of acute thrombosis and another developed a urinoma. No patient had deterioration in renal function. Conclusion Renal autotransplantation is a treatment option of last resort, with acceptable morbidity in patients with intractable, functionally disabling renal pain, but three‐quarters of these patients may develop recurrent pain in the transplant site. A current or past history of depression or absence of haematuria may represent risk factors for a poor post‐operative prognosis. Treatment failure is predictable by a poor response to sympathetic neurolytic block.

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