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Clinical usefulness of the memokath stent as a second-line procedure after sphincterotomy failure
Juergen Pannek1, Konrad Göcking, Ulf Bersch
1Department of Neuro-Urology, Swiss Paraplegic Center, Nottwil, Switzerland. juergen.pannek@paranet.ch
Purpose:
To assess the clinical usefulness of Memokath® stent placement in the external sphincter region in men with neurogenic bladder dysfunction from spinal cord injury after failed sphincterotomy.
Patients And Methods:
Twenty-two men with elevated (> 100 mL) residual urine and/or voiding difficulties/autonomic dysreflexia were treated with a Memokath stent. Follow-up examinations comprised residual urine, video-urodynamics, renal sonography, and assessment of subjective outcome.
Results:
No intraoperative complications were observed. Transient autonomic dysreflexia developed in one patient. Stent repositioning from dislocation was necessary in four (18.2%) patients. After a median follow-up of 10.3 months, 18 (81.8%) patients still had a stent in place. In two men, the stents were removed because of newly diagnosed urothelial bladder cancer; in another two patients, they were removed because of lack of success. At follow-up, residual urine was significantly reduced from 229 to 105 mL. Residual urine was < 100 mL in 14 of 18 (77.8%) patients. Changes in bladder capacity, detrusor leak point pressure, bladder compliance, and maximum detrusor pressure were not statistically significant. Renal sonography did not reveal any pathologic findings.
Conclusions:
According to our data, the Memokath stent is not only an alternative treatment option to sphincterotomy, but it is a safe and successful second-line treatment after sphincterotomy failure.
