Feasibility of a temporary urethral stent through the striated sphincter in patients in the early phase (6 months) of spinal cord injury

Objective: To assess the feasibility of a temporary urethral stent through the striated sphincter in patients in the early phase (before 6 months) of spinal cord injury (SCI) in a department of neurological rehabilitation. Methods: Fourteen consecutive men with SCI with urinary retention within 6 months after SCI were prospectively treated. Thirteen patients were tetrapl egic (C2 to C7) and 1 was paraplegic. All patients were managed with indwel ling catheters (10) or intermittent catheterization (4). The Nissenkorn pol yurethane urethral stent was inserted across the external sphincter under l ocal anesthesia for an anticipated 4-month duration. Results: No perioperative complications were encountered. Hospital mean sta y at the urological department was 1.9 days (range 1-4 days). All patients had good emptying of the bladder (residual urine less than 100 ml) and were free of all types of catheterization. Five stents had to be repositioned i n the first 2 weeks, 1 was removed for obstruction at 2.5 months. There was no lithiasis, no upper urinary tract alteration, no symptomatic infection nor local discomfort during follow-up. At a mean of 3.7 months after implan tation, 10/14 (71.5%) patients chose sphincterotomy by permanent urethral s tent and 4 had stent removal for learning of self-intermittent catheterizat ion (3) and indwelling catheter(l). Conclusions: The temporary sphincter stent is a new, feasible and reversibl e technique to manage neuropathic bladder dysfunction in the early phase af ter SCI. A randomized study on intermittent catheterization should be condu cted. It should consider patients' and nursing care-givers' evaluations. Co pyright (C) 2001 S. Karger AG, Basel.