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[Memotherm as a therapeutic device in infravesical obstruction]
N Osvaldo Bernardo1, J I Iglesias Prieto, J M Mancebo Gómez
1Unidad de Urología, Clínica La Luz, Madrid, España.
Objective:
To determine the efficacy of the intraurethral mesh in the treatment of infravesical obstruction in patients at high surgical risk unamenable to other treatment modalities.
Methods:
We evaluated 13 patients with obstruction and at high risk for conventional surgery (TURP) who underwent insertion of the Memotherm intraurethral prosthesis.
Results:
The procedure was performed rapidly with scant morbidity and the patients were discharged from the hospital early. Improvement, evaluated by the IPSS-L, was referred by 84.6% of the patients at 45 weeks follow up. Post-treatment improvement was evidenced by the absence of postvoiding residual urine at ultrasound in 69.2% of the patients and improved flowmetry in 84.6% of the patients. The early post-treatment complications included hematuria with irritative symptoms (80% of the patients). The mesh prosthesis had migrated in 15%, but could be repositioned. No case required removal of the prosthesis.
Conclusions:
This method affords a rapid and atraumatic solution for obstructed patients at high surgical risk. The material (heat sensitive nitinol) and the design of the mesh facilitate repositioning in the few cases in whom this had been required.