Chancellor M B, Rivas D A, Watanabe T, Bennett J K, Foote J E, Green B G, Killorin E W, MacMillan R
Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
J Urol. 1996 Jun;155(6):1992-4.
We determined whether the self-expanding sphincter stent, a potential alternative to conventional external sphincterotomy for the treatment of detrusor external sphincter dyssynergia, causes a permanent effect on the lower urinary tract.
Four spinal cord injured men with voiding symptoms of detrusor external sphincter dyssynergia as noted by complete urological evaluation, including a video urodynamic study, were treated with the self-expanding sphincter stent. However, the device was explanted 6 months or longer after insertion in all 4 cases due to stent migration (3) and difficulty with condom catheter urinary drainage (1).
All stents were removed completely without damage to the urethra. Mean voiding pressure decreased from 62.5 +/- 39.4 to 20.7 +/- 6.5 cm. water after sphincter stent placement. One year after stent explantation mean voiding pressure remained unchanged from preoperative values of 58.5 +/- 21.5 cm. water. No patient had stress urinary incontinence or endoscopically apparent urethral strictures.
The stent can be removed even after complete epithelialization and an extended interval without damage to external sphincter function or urethral stricture formation. The urinary sphincter stent is an effective, reversible treatment for patients with detrusor external sphincter dyssynergia.
我们确定了自膨式括约肌支架作为治疗逼尿肌-外括约肌协同失调的传统外括约肌切开术的一种潜在替代方法，是否会对下尿路产生永久性影响。
对4名脊髓损伤男性患者进行了自膨式括约肌支架治疗，这些患者经全面的泌尿外科评估（包括视频尿动力学研究）显示存在逼尿肌-外括约肌协同失调的排尿症状。然而，由于支架移位（3例）和使用避孕套导管进行尿液引流困难（1例），所有4例患者在支架植入后6个月或更长时间取出了该装置。
所有支架均被完全取出，未对尿道造成损伤。放置括约肌支架后，平均排尿压力从62.5±39.4厘米水柱降至20.7±6.5厘米水柱。支架取出1年后，平均排尿压力与术前的58.5±21.5厘米水柱值相比没有变化。没有患者出现压力性尿失禁或内镜下明显的尿道狭窄。
即使在完全上皮化且间隔时间延长后，支架也可以取出，而不会损害外括约肌功能或形成尿道狭窄。尿括约肌支架是治疗逼尿肌-外括约肌协同失调患者的一种有效、可逆的治疗方法。
