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Permanent Urethral Stents for Detrusor Sphincter Dyssynergia
Author(s) -
MclNERNEY P. D.,
VANNER T. F.,
HARRIS S. A. B.,
STEPHENSON T. P.
Publication year - 1991
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1991.tb15137.x
Subject(s) - medicine , detrusor sphincter dyssynergia , dyssynergia , neck of urinary bladder , surgery , stent , sphincter , urethral sphincter , urinary incontinence , urinary bladder , urology , neurological disorder , central nervous system disease
Summary— A series of 22 patients, most of whom had spinal injuries with detrusor sphincter dyssynergia, have had Medinvent Wallstents placed across the distal mechanism. All but 8 patients had undergone outflow surgery and 11 had had repeated unsuccessful sphincterotomies. The proximal end of the stent was placed over the verumontanum unless fertility was contemplated, when it was placed immediately below the verumontanum. Fifteen patients achieved complete voiding after placement of the first stent; 3 developed bladder neck obstruction after stenting, but in 1 of these cases resolution occurred after bladder neck incision. The 3 patients with artificial urinary sphincters failed to improve after stenting. Use of the urethral stent for patients with detrusor sphincter dyssynergia and failed sphincterotomy is a major advance. It should probably be the primary treatment in selected cases. Its effect on fertility is currently under assessment.