Clinical Usefulness of the Memokath Stent as a Second-Line Procedure After Sphincterotomy Failure

Pannek, J.; Göcking, K; Bersch, Ulf

doi:10.1089/end.2010.0374

Cited by 10 publications

(3 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Urethral stents can serve as a therapeutic alternative to sphincterotomy both as a primary procedure or to treat a failed sphincterotomy procedure [72]. By strict avoidance of putting the stent through the bladder neck, the incidence of stent encrustation and development of dysreflexia can be minimized.…”

Section: Surgical Interventions For Neurogenic Bladdermentioning

confidence: 99%

Neurogenic Bladder

Dorsher

McIntosh

2012

Advances in Urology

146

126

View full text Add to dashboard Cite

Congenital anomalies such as meningomyelocele and diseases/damage of the central, peripheral, or autonomic nervous systems may produce neurogenic bladder dysfunction, which untreated can result in progressive renal damage, adverse physical effects including decubiti and urinary tract infections, and psychological and social sequelae related to urinary incontinence. A comprehensive bladder-retraining program that incorporates appropriate education, training, medication, and surgical interventions can mitigate the adverse consequences of neurogenic bladder dysfunction and improve both quantity and quality of life. The goals of bladder retraining for neurogenic bladder dysfunction are prevention of urinary incontinence, urinary tract infections, detrusor overdistension, and progressive upper urinary tract damage due to chronic, excessive detrusor pressures. Understanding the physiology and pathophysiology of micturition is essential to select appropriate pharmacologic and surgical interventions to achieve these goals. Future perspectives on potential pharmacological, surgical, and regenerative medicine options for treating neurogenic bladder dysfunction are also presented.

show abstract

Section: Surgical Interventions For Neurogenic Bladdermentioning

confidence: 99%

Neurogenic Bladder

Dorsher

McIntosh

2012

Advances in Urology

146

126

View full text Add to dashboard Cite

show abstract

“…A therapeutic alternative to intrasphincteric BoNT-A injections long-term are urethral sphincter stents. Pannek et al showed their safety and feasibility in patients with SCI after failed surgical sphincterotomy [24], but this method is associated with complications such as stent dislocation or stent stenosis [25,26]. However, evidence for treatment efficacy regarding urethral sphincter stents in patients such as in our cohort is lacking as well.…”

Section: Findings In the Context Of The Existing Literaturementioning

confidence: 81%

The Efficacy and Safety of Intrasphincteric Botulinum Toxin-A Injections in Patients with Non-Spinal Cord Injury-Related Detrusor Sphincter Dyssynergia: A Retrospective Study

Röthlin,

Anding,

Seifert

et al. 2023

Biomedicines

View full text Add to dashboard Cite

Botulinum toxin-A (BoNT-A) injections into the external urethral sphincter are an established therapeutic procedure for reducing bladder outlet obstruction in patients with detrusor sphincter dyssynergia (DSD) due to spinal cord injury (SCI). Given the paucity of data on patients with DSD but without SCI, we aimed to assess the efficacy of intrasphincteric BoNT-A injections in this cohort. For this retrospective study, we screened all patients who underwent their first intrasphincteric BoNT-A injection at our institution between 2015 and 2021. The inclusion criteria were patients aged 18 years or older with neurogenic detrusor overactivity (NDO) and DSD with a maximum detrusor pressure (Pdetmax) of >40 cmH2O, confirmed via video-urodynamic studies (VUDS). The primary outcome was a reduction in Pdetmax and detrusor overactivity leak point pressure (DOLPP) during NDO-associated urinary incontinence posttreatment. The secondary outcome was a reduction in patients relying on indwelling urinary catheters posttreatment. We included 13 eligible patients (all male, median age 31 years, with different underlying neurological disorders, except SCI). All underwent intrasphincteric BoNT-A injections with either 100 (n = 7) or 150 (n = 6) units, respectively. Pdetmax during voiding was significantly reduced posttreatment (median 105 vs. 54 cmH2O, p = 0.006), whereas DOLPP remained unchanged (i.e., median 50 cmH2O). While seven patients relied on indwelling urinary catheters pre-treatment, all were catheter-free posttreatment. Intrasphincteric BoNT-A injections in patients with non-SCI related DSD appear feasible for reducing bladder outlet obstruction to a certain degree in this cohort and subsequently for reducing the rate of indwelling catheters.

show abstract

“…Our results also agreed with those of Pannek et al who noted zero intraoperative complications in their study and did not find significant encrustation, and they postulated that this finding may be because of the stent observation period (13 months). Even in the subset of patients who had a stent for longer periods, they did not encounter encrustation [20]. However, removal was easy, taking about 15 minutes by flushing the stent with cool water < 10°C, which alters the spiral so it becomes soft and pliable in order to facilitate transurethral removal such as that done in the study by Neil et al in which removal took an average of 11 minutes.…”

Section: Discussionmentioning

confidence: 99%

Memokath 044 Stent for the Treatment of Recurrent Bulbar Urethral Strictures

El-Tabey¹

2012

UIJ

View full text Add to dashboard Cite

Introduction: Urethral strictures are first described as causing bladder outlet obstruction in ancient literature dating back to the Greek and Egyptian period. The management of urethral stricture remains a challenge to all urologists, especially for those failing to respond to repeated dilatation or optical urethrotomy, and for strictures recurring after urethroplasty. So the idea is to use stents for preventing stricture recurrence based on mechanical interference, and to prevent the scarring process that ends in contraction. Objective: In this study, we tried to assess the efficacy and safety of the Memokath 044 temporary stent in the treatment of recurrent bulbar urethral strictures. Patients and Methods: Between April 2010 and May 2011, 16 patients presented with bladder outlet obstruction (BOO) due to recurrent bulbar urethral strictures. All underwent Memokath 044 stenting. The stents were inserted endoscopically under local or saddle-block anesthesia. Patients were followed up with Qmax , post-void residual urine (PVR), sexual function, and quality of life (QoL) scores at 2 weeks, 1 month, 3 months, 6 months, and 12 months, post-insertion. Results: All the stents were successfully inserted. The operative time ranged from 20 to 40 minutes (30 ± 6.45) with no intraoperative complications. All patients achieved spontaneous voiding after insertion. The mean Qmax, PVR, and QoL scores significantly improved after the procedure and continued to improve throughout the follow-up period. There were minimal postoperative complications; transient and treated conservatively. Stent migration took place in 6.25% of cases with easy endoscopic repositioning. Obstruction of the stent lumen occurred in 6.25%, which mandated stent removal. Conclusion: The Memokath 044 stent is straightforward to insert and to remove, it can relieve the symptoms of BOO due to recurrent bulbar urethral strictures in surgically risky patients, maintaining urethral patency without affecting sexual intimacy and thereby improving the quality of life.

show abstract

Clinical Usefulness of the Memokath Stent as a Second-Line Procedure After Sphincterotomy Failure

Abstract: 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.

Cited by 10 publications

References 27 publications

Neurogenic Bladder

Neurogenic Bladder

The Efficacy and Safety of Intrasphincteric Botulinum Toxin-A Injections in Patients with Non-Spinal Cord Injury-Related Detrusor Sphincter Dyssynergia: A Retrospective Study

Memokath 044 Stent for the Treatment of Recurrent Bulbar Urethral Strictures

Contact Info

Product

Resources

About