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

Michael B. Chancellor, Jerzy Gajewski, C. F Douglas Ackman, Rodney A. Appell, James Bennett, Joseph Binard, Timothy B. Boone, Michael P. Chetner, Julie Ann Crewalk, Alfred Defalco, Jenelle Foote, Bruce Green, Saad Juma, Suk Young Jung, Todd A. Linsenmeyer, Robert Macmillan, Michael Mayo, Hideo Ozawa, Claus G. Roehrborn, Patrick J. ShenotAnthony Stone, Albert Vazquez, Wylly Killorin, David A. Rivas

Research output: Contribution to journalArticle

53 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1545-1550
Number of pages6
JournalJournal of Urology
Volume161
Issue number5
DOIs
StatePublished - May 1999

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Keywords

  • Spinal cord injuries
  • Stents
  • Urinary incontinence
  • Urinary tract infections
  • Urodynamics

ASJC Scopus subject areas

  • Urology

Cite this

Chancellor, M. B., Gajewski, J., Ackman, C. F. D., Appell, R. A., Bennett, J., Binard, J., Boone, T. B., Chetner, M. P., Crewalk, J. A., Defalco, A., Foote, J., Green, B., Juma, S., Jung, S. Y., Linsenmeyer, T. A., Macmillan, R., Mayo, M., Ozawa, H., Roehrborn, C. G., ... Rivas, D. A. (1999). Long-term followup of the North American multicenter UroLume trial for the treatment of external detrusor-sphincter dyssynergia. Journal of Urology, 161(5), 1545-1550. https://doi.org/10.1016/S0022-5347(05)68950-1