title: Thermo-expandable intra-prostatic stent in the treatment of acute urinary retention in elderly patients with significant co-morbidities.
abstract: We assess the use of thermo-expandable intra-prostatic stent (Memokath, Engineers and Doctors A/S, Denmark) for the treatment of acute urinary retention (AUR) in men with significant co-morbidities for transurethral resection of prostate (TURP). We evaluate the pre- and post-operative complications, duration of stents in-situ and patients quality of life after the stent insertion. Patients with significant co-morbidities presenting with AUR were selected, who were unfit for TURP. The co-morbidities included ischaemic heart disease, congestive heart failure, and chronic obstructive pulmonary disease. The exclusion criteria were bladder tumour and atonic bladder. The Memokath stents were inserted using a flexible cystoscope under local anaesthesia. The patients were followed up at 3 and 6 months after the procedure and the ones who remained alive were asked to complete self-administered questionnaires and IPSS scores. Fifteen men with acute urinary retention were recruited for stent insertion with the mean age of 87 years. No peri-operative complications were recorded. Three patients died after the insertion with functional Memokath in-situ. Nine patients had good functioning stents post-operatively, and remain catheter free up to 30 months after the procedure. The mean duration of stent life was 18 months. Three long-term complications were detected, including stent migration and prostate overgrowth. The Memokath is a good option for frail elderly patients presenting with AUR. The procedure is safe and has minimal long term complications. The stent also provides a sustained good quality of life for patients and avoids the necessity of long term catheterisation.
authors.affiliation: Watford General Hospital, WD18 0HB, Watford, UK. georgeeglee@msn.com
authors.forename: G
authors.initials: G
authors.lastname: Lee
authors.forename: S
authors.initials: S
authors.lastname: Marathe
authors.forename: S
authors.initials: S
authors.lastname: Sabbagh
authors.forename: J
authors.initials: J
authors.lastname: Crisp
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D000075202:Contraindications; D006801:Humans; D008297:Male; D011467:Prostate; D011474:Prosthesis Design; D015607:Stents; D020728:Transurethral Resection of Prostate; D016055:Urinary Retention / Q000453:epidemiology / Q000628:therapy*