Urolume urethral wallstent in the treatment of detrusor sphincter dyssynergia

Juma, Saad; Niku, S. Daniel; Brodak, Philip P.; Joseph, Angela C

doi:10.1038/sc.1994.97

Cited by 17 publications

(6 citation statements)

References 11 publications

(4 reference statements)

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“…An alternative is to make the patient 'safe and wet' by reducing the bladder outlet resistance either by TUS, stent, or botulinum toxin A. 8,9 External spincterotomy has been the treatment of choice for over 30 years. 10 However, potential complications of erectile dysfunctions (2.8-64%), haemorrhage (5-23%), technical failure and re-operation rate (12-26%) have led to alternatives.…”

Section: Discussionmentioning

confidence: 99%

Memokath® stents for the treatment of detrusor sphincter dyssynergia (DSD) in men with spinal cord injury: The Princess Royal Spinal Injuries Unit 10-year experience

Mehta

Tophill

2005

Spinal Cord

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thermosensitive stent as a 'nondestructive' means of reducing bladder outlet resistance by treating detrusor sphincter dyssynergia (DSD) of neurogenic bladder dysfunction associated with spinal cord injury. Setting: Spinal Injuries Unit, Sheffield, England. Methods: A medical records review was performed to examine our experience of Memokaths over the last 10 years. During this time, 29 patients with spinal cord injury (17 tetraplegic and 12 paraplegic) underwent stenting of the external urethral sphincter either for prevention of dysreflexic symptoms, high residual urine volumes and subsequent urinary tract infection (UTI) or for protection of the upper tracts. Results: A total of 33 stents were inserted into 29 men (25-77 years) with suprasacral spinal cord injury. Initial results showed that the Memokath was effective in almost all for relief of dysreflexic symptoms and elimination of DSD on pressure flow urodynamics. However, to date, 30 of the 33 stents have been removed. The overall mean working life of the Memokath was 21 months. Four stents were removed electively and 23 for complications, which included stent migration (seven) and blockage (14). Single-ended stents were more prone to migration, which was rare after 1 year (1-13 months, median 3 months, mean 5.5 months). Stent blockage by encrustation or prostatic ingrowth did not occur before 12 months (12-45 months, median 30, mean 27.9 months). Conclusions: In selected patients, temporary, thermo-expandable (Memokath) stents are effective in the treatment of DSD. The 'working life' of a Memokath stent is 21 months; however, complications do occur which may necessitate removal. Our overall experience with Memokath stents was disappointing. In future, Memokath stents will only be inserted after careful consideration in patients with prior 'failed' transurethral sphincterotomy or with caution in patients suitable for reconstructive surgery.

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Section: Discussionmentioning

confidence: 99%

Memokath® stents for the treatment of detrusor sphincter dyssynergia (DSD) in men with spinal cord injury: The Princess Royal Spinal Injuries Unit 10-year experience

Mehta

Tophill

2005

Spinal Cord

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“…Other stent types have been used for BPH, detrusor sphincter dysynergia, urethral strictures and prostate cancer [11,12,13,14,15,16]. In previous studies, using different stents, 10-49% of stents had to be removed because of major side effects [16].…”

Section: Discussionmentioning

confidence: 99%

“…Later they were also used for bladder outflow obstruction, external detrusor sphincter dysynergia, urethral strictures, and prostate cancer [11,12,13,14,15,16]. Overall 10-49% of the stents placed for BPH had to be removed because of side effects [16], such as migration, voiding symptoms (especially urgency), perineal pain and encrustation [17,18].…”

Section: Introductionmentioning

confidence: 99%

The Use of a Memokath Prostatic Stent for Obstructive Voiding Symptoms after Brachytherapy

Graaf¹,

Stijns²,

Scheepens³

et al. 2013

Current Urology

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Introduction: Brachytherapy may be complicated by serious obstructive voiding symptoms (OVS). Only conservative treatment options are available in the first 6 months after brachytherapy. We evaluated safety, efficacy and patient tolerance of the Memokath prostatic stent (MPS). Material and Methods: A MPS was placed in 10 patients with OVS after brachytherapy. Evaluation included uroflowmetry, international prostate symptom score (IPSS), prostate volume and urethrocystoscopy before and 3 months after placement of the stent. Results: Both the IPSS and uroflowmetry results significantly improved after stent insertion. The mean IPSS decreased from 29/5 to 11/1 and the mean Qmax from the uroflowmetry improved from 4.7 to 11.2 ml/s. The 5 patients who were catheter dependent voided spontaneously with a mean Qmax of 15 ml/s. Two stents migrated towards the bladder, and those patients needed a second stent which was placed without complications. Removal of the stent was easy to perform. Adverse effects were minor with perineal pain and irritative voiding symptoms occurring in 5 patients mainly in the first weeks after insertion. This did not negatively influence quality of life and all patients were more satisfied with the stent than without. Conclusions: The MPS provides a safe, effective, and completely reversible treatment for patients with OVS after brachytherapy and was well tolerated.

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“…The long‐term use of indwelling catheters has been shown to be associated with squamous cell carcinoma in ≈ 5% of these patients [7,8]. Several recent reports suggest botulinum toxin A is useful for DESD in the spinally injured patient [9], but unfortunately the results are erratic and the treatment has to be repeated at 9–18 months.…”

Section: Introductionmentioning

confidence: 99%

The mesh wallstent in the treatment of detrusor external sphincter dyssynergia in men with spinal cord injury: a 12‐year follow‐up

Hamid¹,

Arya²,

Patel³

et al. 2003

BJU International

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OBJECTIVETo assess the long-term effectiveness of the UroLume™ wallstent (Pfizer Inc., UK) in the treatment of detrusor external sphincter dyssynergia (DESD) in quadriplegic patients. PATIENTS AND METHODSTwelve patients with quadriplegia secondary to spinal trauma underwent external striated sphincter stenting with the UroLume wallstent instead of an external sphincterotomy for DESD (mean age 41.8 years, range 26-65). The level of injury was C4 in two, C5 in four, C6 in four, C7 in one and T6 in one. All patients were shown by preoperative videocystometrography (VCMG) to have DESD and high-pressure, hyper-reflexic bladders with incomplete emptying.

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Urolume urethral wallstent in the treatment of detrusor sphincter dyssynergia

Cited by 17 publications

References 11 publications

Memokath® stents for the treatment of detrusor sphincter dyssynergia (DSD) in men with spinal cord injury: The Princess Royal Spinal Injuries Unit 10-year experience

Memokath® stents for the treatment of detrusor sphincter dyssynergia (DSD) in men with spinal cord injury: The Princess Royal Spinal Injuries Unit 10-year experience

The Use of a Memokath Prostatic Stent for Obstructive Voiding Symptoms after Brachytherapy

The mesh wallstent in the treatment of detrusor external sphincter dyssynergia in men with spinal cord injury: a 12‐year follow‐up

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