Intraurethral stent prosthesis in spinal cord injured patients with sphincter dyssynergia

This study is an analysis of the Memotherm(R) prosthesis in spinal cord inj ured patients with Detrusor-external sphincter dyssynergia (DESD). Twenty-f our patients were evaluated urodynamically before and after placement of th e intraurethral stent prosthesis. All the patients had been chronically man aged with an indwelling urinary catheter, intermittent catheterization or c ondom catheters. Sixty-six per cent had history of recurrent urinary tract infection, 37% had symptoms of autonomic dysreflexia. Nine patients had pre vious 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 ins ertion. Stent insertion was accomplished without any operative complication s. 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.