Memokath-028, 044 and 045 stents for urethral obstruction

The technologies described in this briefing are the Memokath‑028, Memokath‑044 and Memokath‑045 stents. They are used to relieve urethral obstructions and bladder neck or outlet obstructions.

The innovative aspects are that the stents are designed to be easily inserted and removed compared with other urethral stents or indwelling catheters.

The intended place in therapy for Memokath‑028 would be as an alternative to self-catheterisation, long-term indwelling catheterisation or some types of surgery in patients with enlarged prostates. The Memokath‑044 and 045 stents would be used in addition to urethral dilation, urethrotomy or urethroplasty to maintain urethral width for longer periods, or as an alternative to surgery.

The main points from the evidence summarised in this briefing are from 11 studies. For Memokath‑028, there is a systematic review and 3 observational studies (2 in Japan, 1 in the Netherlands) including a total of 1,013 patients. For Memokath‑044, there are 4 studies including 1 randomised controlled trial (US), 2 observational studies (Egypt, Australia) and 1 pilot study (Italy) including a total of 153 patients. For Memokath‑045, there are 2 retrospective studies (South Africa, UK) and 1 observational study (Switzerland) including a total of 75 patients. These studies reported variable results but generally show that all 3 Memokath stents are effective in treating urethral obstructions. The most commonly reported adverse events were stent migration for Memokath‑028, encrustation for Memokath‑044 and urinary tract infection and stent failure because of migration for Memokath‑045.

Key uncertainties around the evidence or technology are that the evidence base is still developing with, as yet, few relevant direct comparisons.

The costs of Memokath‑028, Memokath‑044 and Memokath‑045 are £945, £945 and £1,150 per unit respectively (exclusive of VAT). The resource impact would be similar to standard care, or lower if use of the stents led to fewer infections and reduced usage of other resources, for example through avoiding surgery.