title: Reversible clinical outcome after sphincter stent removal.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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).
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
authors.forename: M B
authors.initials: MB
authors.lastname: Chancellor
authors.forename: D A
authors.initials: DA
authors.lastname: Rivas
authors.forename: T
authors.initials: T
authors.lastname: Watanabe
authors.forename: J K
authors.initials: JK
authors.lastname: Bennett
authors.forename: J E
authors.initials: JE
authors.lastname: Foote
authors.forename: B G
authors.initials: BG
authors.lastname: Green
authors.forename: E W
authors.initials: EW
authors.lastname: Killorin
authors.forename: R
authors.initials: R
authors.lastname: MacMillan
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D013119:Spinal Cord Injuries / Q000150:complications; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014521:Urethra / Q000503:physiopathology; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000628:therapy*; D014563:Urodynamics