Early experience of the use of permanently implanted prostatic stents for the treatment of bladder outflow obstruction

Summary

As an alternative to transurethral resection for bladder outflow obstruction, 108 patients underwent insertion of a Urolume prostatic stent (A.M.S.) and 56 received an ASI stent; the maximal follow-up was 21 months. The majority of patients were of ASA (American Society of Anaesthesiologists) grades III and IV. All patients with normal detrusor function became capable of voiding. Up to 25% of subjects developed urgency and some, urge incontinence during the first few weeks after stent insertion. There was a progressive reduction in asymptomatic bacteriuria with time, the majority of stents becoming covered with urothelium by 6 months. Fine calcification on the surface of the Urolume stent was seen in six cases and stone formation was observed in one, occurring in areas of non-epithelialisation. Permanently implanted prostatic stents are an effective alternative to transurethral resection or a permanent indwelling catheter, but a longer follow-up period in a larger group of patients is required before these devices can be recommended for routine use.