Long-term followup of the North American multicenter UroLume trial for the treatment of external detrusor-sphincter dyssynergia.

Abstract

PURPOSE:

We determine the long-term efficacy and safety of the UroLume stent as minimally invasive treatment for external detrusor-sphincter dyssynergia in spinal cord injured men.

MATERIALS AND METHODS:

A total of 160 spinal cord injured men with a mean age plus or minus standard deviation of 36.3 +/- 12.1 years (range 16 to 74) were prospectively treated with an endoprosthesis at 15 centers as part of the North American UroLume trial for external detrusor-sphincter dyssynergia. Urodynamic parameters, including voiding pressure, residual urine volume and bladder capacity, were compared before treatment and at 1, 2, 3, 4 and 5 years after treatment.

RESULTS:

Mean voiding pressure was 75.1 +/- 28.2 cm. water before treatment in the 160 patients, and 37.4 +/- 23.9 at year 1 in 97, 39.5 +/- 22.2 at year 2 in 84, 42.6 +/- 27.3 at year 3 in 61, 46.3 +/- 33.2 at year 4 in 57 and 44.2 +/- 28.9 cm. at year 5 in 41 after stent insertion (p <0.001). Residual urine volume decreased after stent placement and was maintained throughout the 5-year followup (p <0.001). Mean cystometric capacity remained constant from 269 +/- 155 before insertion to 337 +/- 182 ml. 5 years later (p = 0.17). Hydronephrosis and autonomic dysreflexia improved or stabilized in most patients with functioning stents. Stent explant was necessary in 24 patients (15%), of whom 4 (16.7%) had another stent implanted.

CONCLUSIONS:

The UroLume stent demonstrates long-term safety and efficacy for the treatment of external detrusor-sphincter dyssynergia. The outcome was similar in men with and without previous sphincterotomy.

• Authors: M B Chancellor, J Gajewski, C F Ackman, R A Appell, J Bennett, J Binard, T B Boone, M P Chetner, J A Crewalk, A Defalco, J Foote, B Green, S Juma, S Y Jung, T A Linsenmeyer, R MacMillan, M Mayo, H Ozawa, C G Roehrborn, P J Shenot, A Stone, A Vazquez, W Killorin, D A Rivas
• Journal: The Journal of urology (J Urol) Vol. 161 Issue 5 Pg. 1545-50 (May 1999) ISSN: 0022-5347 [Print] United States
• PMID: 10210393 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Aged
• Autonomic Nervous System (physiopathology)
• Canada
• Follow-Up Studies
• Humans
• Hydronephrosis (epidemiology, etiology)
• Male
• Middle Aged
• Penile Erection
• Postoperative Complications (epidemiology)
• Spinal Cord Injuries (complications, physiopathology)
• Stents
• Time Factors
• United States
• Urinary Catheterization
• Urinary Incontinence (etiology, physiopathology, therapy)
• Urinary Tract Infections (epidemiology, etiology)
• Urodynamics