PLACEMENT OF A WIRE MESH PROSTHESIS IN THE EXTERNAL URINARY SPHINCTER OF MEN WITH SPINAL-CORD INJURIES

被引:25
作者
CHANCELLOR, MB
KARUSICK, S
ERHARD, MJ
ABDILL, CK
LIU, JB
GOLDBERG, BB
STAAS, WE
机构
[1] THOMAS JEFFERSON UNIV,JEFFERSON MED COLL,DEPT RADIOL,PHILADELPHIA,PA 19107
[2] THOMAS JEFFERSON UNIV,PHILADELPHIA,PA 19107
[3] MAGEE REHABILIT HOSP,PHILADELPHIA,PA
关键词
PARALYSIS; PROSTHESES; SPINAL CORD; INJURIES; URETHRA; INTERVENTIONAL PROCEDURE; STENOSIS OR OBSTRUCTION; URODYNAMICS;
D O I
10.1148/radiology.187.2.8475306
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
The authors report their experience with an intraurethral prosthetic stent as an alternative treatment for detrusor-external urethral sphincter dyssynergia (DESD). A sphincter prosthesis was inserted into the membranous urethra of 25 men with spinal cord injuries, DESD, and elevated voiding pressure. Bladder voiding pressure decreased from 87 cm H2O +/- 23 to 27 cm H2O +/- 11 in 12 months (P < .001). There was a significant decrease in residual urine volume 12 months after prosthesis placement, from 122 mL +/- 77 to 33 mL +/- 19 (P < .01); bladder capacity remained relatively unchanged, from 174 mL +/- 84 to 230 mL +/- 92 (P < .57). No deleterious effects were seen in renal or erectile function. Migration of three prostheses occurred 1 day to 6 weeks after insertion. One additional complication, pyelonephritis, occurred in a patient with preexisting vesicoureteral reflux, necessitating reimplantation of bilateral ureters. The intraurethral wire mesh prosthesis, with its simplicity of placement and minimal associated morbidity, offers a potential alternative to external sphincterotomy.
引用
收藏
页码:551 / 555
页数:5
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