Intraurethral stent prosthesis in spinal cord injured patients with sphincter dyssynergia

This study is an analysis of the Memotherm(R) prosthesis in spinal cord injured patients with Detrusor-external sphincter dyssynergia (DESD). Twenty-four patients were evaluated urodynamically before and after placement of the intraurethral stent prosthesis. All the patients had been chronically managed with an indwelling urinary catheter, intermittent catheterization or condom catheters. Sixty-six per cent had history of recurrent urinary tract infection, 37% had symptoms of autonomic dysreflexia. Nine patients had previous external sphincterotomy. Follow-up ranged from 3-39 months (mean 15.4 months). After stent insertion all patients were able to achieve spontaneous reflex voiding with the use of condom catheter. Postoperative urodynamics parameters bladder leak point pressure and residual urine volume decreased significantly after stent insertion. Stent insertion was accomplished without any operative complications. In four patients stent migration (16%) required telescoping a new system over the migrated stent. In two patients the stent was removed because of problems of infection and calculus formation. In conclusion, this system (Memotherm(R)) is an attractive, and potentially reversible treatment for DESD in SCI patients.