McInerney P D, Vanner T F, Harris S A, Stephenson T P
Department of Urology, Royal Infirmary, Cardiff.
Br J Urol. 1991 Mar;67(3):291-4. doi: 10.1111/j.1464-410x.1991.tb15137.x.
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.
22例患者接受了Medinvent Wallstents支架植入术，横跨远端机制，其中大多数患者患有脊髓损伤并伴有逼尿肌括约肌协同失调。除8例患者外，其余患者均接受了流出道手术，11例患者反复进行括约肌切开术但均未成功。除非考虑生育问题，否则支架近端置于精阜上方，若考虑生育，则置于精阜下方。15例患者在植入第一个支架后实现了完全排尿；3例患者在支架植入后出现膀胱颈梗阻，但其中1例在膀胱颈切开术后梗阻缓解。3例植入人工尿道括约肌的患者在支架植入后症状未改善。对于逼尿肌括约肌协同失调且括约肌切开术失败的患者，使用尿道支架是一项重大进展。在某些特定病例中，它可能应作为主要治疗方法。目前正在评估其对生育能力的影响。
