Treatment of high-risk patients with subvesical obstruction from advanced prostatic carcinoma using a thermosensitive mesh stent.
OBJECTIVE
To evaluate the results obtained using a permanent prostatic stent system (Memotherm, Bard/ Angiomed, Karlsruhe, Germany) in high-risk patients with advanced prostatic carcinoma and subvesical obstruction.


METHODS
The study included 35 patients (mean age 75.3 years, range 53-89) with advanced prostatic carcinoma and persistent subvesical obstruction despite androgen ablation. Because of serious concurrent diseases, 49% of these patients were classified as American Society of Anesthesiologists (ASA) grade 3 and 51% as ASA grade 4. The patients were treated using the Memotherm stent, a thermosensitive Nitinol mesh stent. The outcome was assessed by measuring voiding variables, a symptom score and as the incidence of complications.


RESULTS
After inserting the stent, 33 (94%) of the patients were able to void spontaneously and there was a statistically significant improvement in the voiding variables. These results remained unchanged over a mean (range) follow-up of 15.2 months (3-38). There were no serious complications arising from the insertion of the stent.


CONCLUSIONS
For high-risk patients with subvesical obstruction caused by prostatic carcinoma, the insertion of a permanent metal stent system offers a useful alternative treatment to transurethral resection.
Gottfried
H W
HW
Department of Urology, University of Ulm, Germany.
Gnann
R
R
Brändle
E
E
Bachor
R
R
Gschwend
J E
JE
Kleinschmidt
K
K
D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000150:complications*; D015607:Stents; D014524:Urethral Obstruction / Q000209:etiology / Q000601:surgery*
D000497:Alloys; C013616:nitinol