Abstract
BackgroundMemokath urethral sphincter stents are used to facilitate bladder emptying in patients with spinal cord injury, but long term follow-up has not been reported.MethodsCase series of ten men with spinal cord injury who underwent insertion of Memokath stents and were followed for up to nine years.ResultsWithin four years, the stent had to be removed in nine out of ten patients because of: extensive mucosal proliferation causing obstruction to the lumen of the stent; stone around the proximal end of the stent, incomplete bladder emptying, and recurrent urinary infections; migration of the stent into the bladder related to digital evacuation of bowels; large residual urine; concretions within the stent causing obstruction to flow of urine, and partial blockage of the stent causing frequent episodes of autonomic dysreflexia. In one patient the stent continued to function satisfactorily after nine years.ConclusionsThe Memokath stent has a role as a temporary measure for treatment of detrusor-sphincter dyssynergia in selected SCI patients who do not get recurrent urinary infection and do not require manual evacuation of bowels.
Highlights
Memokath urethral sphincter stents are used to facilitate bladder emptying in patients with spinal cord injury, but long term follow-up has not been reported
We reported our preliminary experience of using the Memokath urethral stent to facilitate bladder emptying in ten men with spinal cord injury
Selection of patients Men with spinal cord injury and urinary retention due to detrusor-sphincter dyssynergia were selected for insertion of a Memokath urethral sphincter stent
Summary
Patient 1 developed difficulty in passing urine five months after stent insertion. Patient 3 developed sweating and difficulty in emptying his bladder eight months after stent insertion. Patient 7 developed urinary infections 30 months after insertion of a Memokath stent. Intravenous urography performed 18 months after insertion of a Memokath stent, revealed poor visualisation of the urinary bladder due to dilute contrast. The remainder of the stent, along with a pearshaped stone, was removed from the bladder through the suprapubic wound Patient 10 had been passing urine satisfactorily through a penile sheath for nearly nine years after insertion of Memokath stent. We believe that Memokath stent has a role as a temporary measure to cure detrusorsphincter dyssynergia in selected SCI patients, who do not get recurrent urinary infection, and do not require manual evacuation of bowels
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