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Thread: What Doc is right

  1. #1
    Junior Member
    Join Date
    Feb 2003
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    ONT CAN
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    What Doc is right

    I had my sphinster muscle cut and it grew back I asked the urologist about having a urloom?inserted (it's a meshed spring device) and he told me I could not have it inserted now. I seen another urologist and he said he could inserted one. I could use some input, and what are the pro's and con's to having one put in.

  2. #2
    Hey Norm,

    I'm not sure who's right... I think you'd get more replies if this was in Care, so I'll close this topic and copy it to there.

    -Steven

  3. #3
    Norm P - I cannot answer your question. I will ask the SCI-nurse team for their guidance. CRF

  4. #4
    Hi, Norm,

    I think you're meaning 'Urolume'; here's a link that tells more about what it is:Urolume site

    Just living is not enough... One must have sunshine,freedom, and a little flower. -
    Hans Christian Anderson

  5. #5
    Norm P - Any self health care decision is always difficult, and even more so when you have been given opinions that oppose one another. KLD has offered some detailed information about the urolume and sphincterotomies. Her reply offers some information that may help you form questions to ask of your physician to help with a final decision.

    By KLD: We have put a Urolume into several patients who have had previous surgical sphincterotomies. There is a somewhat higher risk of migration though (which may require stent removal if it shifts away from the desired area, either up toward the bladder or further down the urethra).

    Advantages of the Urolume are that there is little or no bleeding, no risk of impotence, and at least in theory it can be removed (one wire at a time...a VERY tedious surgery). No urethral catheterization is allowed for any reason for 3-6 months post placement until it grows in place, which can be a problem if the man runs a residual or if he has AD, so alternatives must be planned. AD may require emergency placement of a SP catheter. We have had a few patients who had hypertrophic scarring in the lumen of the stent, requiring removal of the stent and the scar tissue and another regular sphincterotomy (after several weeks with a foley).

    A few patients with REALLY strong sphincter tone have been able to squeeze the stent closed, and these also have had to have it removed and a regular sphincterotomy done.

    As with any new surgery, this procedure should be done by an experienced surgeon...not just one who has used the Urolume for BPH, but one who has used in MS or SCI extensively. There is a "learning curve".

    From RAB: .....Sphincterotomy is a procedure where a urologist goes in with a fiber optic scope and cuts the external urinary spincter so that it can't close off the urethra any more. A stent is similar in that the urologist inserts a metal mesh tube that holds the sphincter open. Spincterotomies often have to be repeated because the cut scars up and the tube closes down. As men age with a spinal cord injury, the often reach a point where the bladder stops squeezing the urine out. When this happens to a person with a sphincterotomy or stent, they have to switch over to an indwelling catheter in order to actually drain the bladder............

    Hope this helps! CRF

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