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Urethral Stents for Neurogenic Bladder Dysfunction

  • Ian K. Walsh
  • Anthony R. Stone
Chapter
Part of the Current Clinical Urology book series (CCU)

Abstract

In the United States alone, more than 10,000 traumatic spinal cord injuries occur each year, predominantly affecting males in the 20–40-yrold age group (1,2). Spinal cord injury may also result from myelopathy, myelitis, arachnoiditis, vascular disease, or arteriovenous malformations. Traumatic lesions are most commonly sited at the thoracolumbar vertebral level, corresponding to the suprasacral spinal cord. In patients with suprasacral, subpontine lesions, the typical neurogenic bladder behavior pattern emerges as one of involuntary external sphincter contraction occurring simultaneously with hyperreflexic detrusor contractions. This detrusor-sphincter dyssynergia (DSD) results in dangerously high intravesical pressures, which pose significant risks for the upper tracts, with complications such as vesicoureteral reflux, hydronephrosis, calculus formation, sepsis, and renal decompensation occurring in more than 50% of patients if left untreated (3). Current management of DSD is directed toward reducing intravesical pressures with antimuscarinic medication and minimizing intravesical volumes via intermittent catheterization. Most paraplegics, however, lack the level of manual dexterity required to self-catheterize effectively and must rely upon intermittent catheterization by their care taker.

Keywords

Spinal Cord Injury Stent Placement External Sphincter Stent Migration Urethral Stricture 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 2002

Authors and Affiliations

  • Ian K. Walsh
  • Anthony R. Stone

There are no affiliations available

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