Urethral Stents for Detrusor Sphincter Dyssynergia

Nambirajan, Thiagarajan; Woolsey, Siobhan; Mahendra, V.; Stone, Anthony R.; Walsh, Ian

doi:10.1016/s0022-5347(05)01051-7

Cited by 2 publications

(2 citation statements)

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“…31 Often, it is necessary to remove the stent, wire by wire, after resection of overlying U. 32 In spite of it, we have removed permanent stents with minimal complications and no lasting consequences. Most withdrawals are conducted within the first year and are mainly owing to inappropriate implantation or displacement.…”

Section: Discussionmentioning

confidence: 99%

Long-term follow-up study of intraurethral stents in spinal cord injured patients with detrusor-sphincter dyssynergia

R-Losada

Montoto-Marqués

et al. 2007

Spinal Cord

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Study design: Retrospective study. Objectives: To assess in the long-term clinical and urodynamic results of intraurethral stents in a group of patients with spinal cord injury. Setting: Spinal Cord Injury Unit, Juan Canalejo Hospital, A Corun˜a, Spain. Methods: Forty-seven consecutive male patients were studied from 1993 to 2002. All of them suffered from hyperreflexia with detrusor-sphincter dyssynergia (DSD) owing to spinal cord injury, and were treated by means of the placement of an intraurethral stent at the external sphincter. Results: After surgery, significant decreases in all the parameters studied were observed. The number of patients with symptoms of urinary tract infection decreased by 25% (Po0.031). Post-void residual urine volume experienced an average decrease of 224.3 cm 3 (P ¼ 0.001). Episodes of dysreflexia decreased from 35.1 to 16.2% (P ¼ 0.039). The urodynamic study showed an average reduction of 44.36 cm H 2 O in the maximum detrusor pressure (Po0.0001). Complications in the upper urinary tract descended from 46.8 to 23.4% after placing the stent (P ¼ 0.013). The most frequent stent complication was displacement, followed by stenosis, lithiasis and intraprosthetic calcification. In all, 8.5% required the stent removal. Conclusions: Intraurethral stent is a good choice for the long-term management of DSD in spinal cord-injured patients, even in those who had been previously submitted to prior sphincterotomy. It has the advantage of being a potentially reversible procedure, so patients prefer it to more invasive therapies such as sphincterotomy.

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Section: Discussionmentioning

confidence: 99%

Long-term follow-up study of intraurethral stents in spinal cord injured patients with detrusor-sphincter dyssynergia

R-Losada

Montoto-Marqués

et al. 2007

Spinal Cord

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“…These interventions may be accompanied by intermittent catheterization 52 . Urethral stents, consisting in the implantation of a rigid and noncompressible material across the external sphincter to maintain urethral patency, may also be used 59‐61 . However, none of these options are completely effective and may be associated with bothersome side effects, including increased risk of urinary infections.…”

Section: Impact Of Urethral Dysfunction In Lut Activitymentioning

confidence: 99%

The urethra in continence and sensation: Neural aspects of urethral function

Ferreira

Cruz

2021

Neurourology and Urodynamics

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Aims: Traditionally, the urethra has been considered a mere conduit to guide urine from the bladder to the external side of the body. Building evidence indicates that the urethra may directly influence bladder function via mechanisms restricted to the lower urinary tract (LUT). Methods: Here, we discuss the tissue arrangement of the urethra and addressed the contribution of new paraneuronal cells to LUT function. We also briefly reviewed two frequent LUT pathologies associated with urethral dysfunction. Results: Continence depends on an intact and functional urethral sphincter, composed of smooth, and striated muscle fibers and regulated by somatic and autonomic fibers. Recent studies suggest the existence of an urethro-vesical reflex that also contributes to normal LUT function. Indeed, the urethral lumen is lined by a specialized epithelium, the urothelium, in the proximal urethra. In this region, recent evidence demonstrates the presence of specific paraneuronal cells, expressing the neurotransmitters acetylcholine and serotonin. These cells are in close proximity of nerve fibers coursing in the lamina propria and are able to release neurotransmitters and rapidly induce detrusor contractions, supporting the existence of an urethro-vesical crosstalk. Conclusion: The mechanism underlying the fast communication between the urethra and thebladder are beginning to be understood and should involve the interaction between specificepithelial cells and fibres innervating the urethral wall. It is likely that this reflex should bealtered in pathological conditions, becoming an attractive therapeutic target.

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Urethral Stents for Detrusor Sphincter Dyssynergia

Cited by 2 publications

References 0 publications

Long-term follow-up study of intraurethral stents in spinal cord injured patients with detrusor-sphincter dyssynergia

Long-term follow-up study of intraurethral stents in spinal cord injured patients with detrusor-sphincter dyssynergia

The urethra in continence and sensation: Neural aspects of urethral function

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