Clinical usefulness of the memokath stent as a second-line procedure after sphincterotomy failure.

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.