Memokath-028, 044 and 045 stents for urethral obstruction

Level of innovation

Two of the commentators agreed that the stents were innovative, with 1 noting that the stents represented a variation on existing technologies and that the innovative aspect was their thermo-expandable properties. The third commentator thought that the stents represented a modification on a device that has been available for almost 20 years.

Potential patient impact

One specialist commentator thought that the Memokath stents could improve health outcomes in people who cannot have general anaesthetic and surgery, and another noted that they could be particularly beneficial to older men with urinary retention. A third commentator thought that the Memokath stents could be beneficial in the short term for men with spinal cord injuries, as well as those who cannot have prostatic surgery, but noted that higher quality evidence with longer follow-up times and cost analyses were needed to confirm this.

The commentators noted that using Memokath stents could mean fewer hospital visits and less invasive treatment options for patients, although 1 noted that more evidence was needed to prove these potential benefits. One commentator compared the Memokath‑028 favourably with long-term indwelling catheterisation, saying that quality of life would be improved and there would be reduced risk of catheter-associated urinary tract infection, and therefore reduced hospital admissions.

Potential system impact

All of the commentators noted that users of the Memokath stents would need special training, for example in how to deploy the stent and how to assess the length of stent needed. They thought that no or very few changes to current NHS facilities or infrastructure would be needed for the stents to be used.

One commentator thought that that use of the Memokath stents was unlikely to lead to cost savings for the NHS and could actually increase costs. Another commentator thought that use of the stents would have a positive impact on NHS services because fewer hospital attendances and admissions would be needed. They added that there may be reduced demand for community nursing services from men who had a Memokath stent inserted, because they may need less frequent catheter changes. The commentator thought that cost savings for the NHS could be significant through a reduced need for consumables such as catheters and associated equipment.

A third commentator stated that using Memokath‑028 has been shown to be less expensive overall than long-term catheterisation or TURP.

General comments

Two of the commentators noted that although the company states that the Memokath‑045 can be used in both women and men, they would not support the use of the stent in the female urethra. They felt that there was insufficient evidence to support its use in women.

One commentator felt strongly that the quality of the evidence supporting the use of the Memokath stents was very poor, and that robust randomised controlled trials and cost-effectiveness studies were needed before they could be actively promoted into wider clinical practice. They argued that, at present, the stents should only be used in a research setting and not in clinical practice.

One commentator remarked that, in their experience, permanent urethral stents are no longer used in NHS clinical practice.

None of the specialist commentators were aware of any safety issues associated with any of the Memokath stents.