Management of Sphincter Dyssynergia Using the Sphincter Stent Prosthesis in Chronically Catheterized SCI Men
| Autor: | Michael B. Chancellor, David A. Rivas, Caryn K. Abdill, William E. Staas, Carol J. Bennett, Michael V. Finocchiaro, Salmon Razi, James K. Bennett, Bruce G. Green, Jenelle E. Foote, R. Wily Killorian |
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| Rok vydání: | 1995 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Urology Prosthesis Dyssynergia medicine Humans Urinary Bladder Neurogenic Hydronephrosis Spinal Cord Injuries Aged Urinary bladder business.industry Urethral sphincter Stent Middle Aged medicine.disease Surgery Urodynamics Urinary Incontinence Urethra medicine.anatomical_structure Urinary Sphincter Artificial Sphincter Neurology (clinical) business Follow-Up Studies |
| Zdroj: | The Journal of Spinal Cord Medicine. 18:88-94 |
| ISSN: | 2045-7723 1079-0268 |
| Popis: | This effort represents a subset analysis of the long-term Multicenter North American Trial of the UroLume sphincter stent prosthesis to determine the effect of the sphincter stent prosthesis in SCI men afflicted with detrusor-external sphincter dyssynergia (DESD) and chronically managed with an indwelling urinary catheter. Forty-one of 153 male patients in this study were evaluated urodynamically before and after placement of the sphincter stent prosthesis. Of the 41 patients, 34 (81 percent) suffered cervical-level injury while 10 patients (25 percent) had been treated previously with external sphincterotomy. Forty patients (98 percent) were troubled with recurrent urinary tract infections (UTI), with a mean of 4.6 +/- 3 episodes of UTI per year. Seven patients (17 percent) demonstrated hydronephrosis prior to stent placement. Follow-up ranged from six to 44 months. Voiding pressures decreased from a mean of 77 +/- 23 cmH2O preoperatively to 35 +/- 18 cmH2O at 12 months (n = 34) and 33 +/- 20 cmH2O at 24 months (n = 22) after stent insertion (p = 0.001). Post-void residual urinary volume decreased from 202 +/- 187 ml preinsertion to 64 +/- 69 ml at 24 months (p = 0.001) postinsertion. Maximum cystometric capacity remained constant at 201 +/- 144 ml preinsertion to 203 +/- 79 ml at 24 months (p = 0.75) postinsertion. No significant changes in any of the urodynamic parameters occurred after 24 months of follow-up between patients with (n = 10) and without (n = 31) previous external sphincterotomy. Neither hemorrhage requiring blood transfusion, obstructive hyperplastic epithelial overgrowth, stent encrustation or stone formation, nor soft tissue erosion occurred in any patient.(ABSTRACT TRUNCATED AT 250 WORDS) |
| Databáze: | OpenAIRE |
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