Efficacy of a thermoexpandable metallic prostate stent (Memokath) in elderly patients with urethral obstruction requiring long-term management with urethral Foley catheters.
OBJECTIVE
To investigate whether the insertion of a thermoexpandable metallic prostate stent (Memokath) facilitates the removal of Foley catheters in elderly patients ineligible for urethral obstruction surgery because of the potential complications involved in long-term catheter management.


METHODS
A total of 37 male patients (mean age 79.8 ± 6.2 years) ineligible for surgery under general anesthesia because of advanced age, the presence of post-cerebrovascular disorders or anticoagulant therapy use and who subsequently had a Memokath stent inserted between June 2007 and November 2009 were enrolled in the present study. Patients with spinal injury were excluded. We compared the correlation between prostatic urethral length and total prostate volume (TPV). We also evaluated the postoperative postvoid residual (PVR) and presence of pyuria, and reviewed postoperative complications and unassisted urination ability.


RESULTS
We found a positive correlation between prostatic urethral length and TPV. After the insertion of the Memokath stent, the catheters were removed from all patients who could urinate unassisted. The PVR was <50 mL in 76.4% patients, and there was a 52% improvement in pyuria after insertion of the Memokath stent. The mean postoperative follow-up duration was 33.2 ± 16.7 months. A total of 21 patients (56.7%) were able to urinate unassisted after receiving the Memokath stent. Unassisted urination was difficult in patients with poor performance status. No serious complications were observed after insertion of the Memokath stent.


CONCLUSIONS
The Memokath stent was safe and useful for elderly patients with urethral obstruction and good performance status requiring long-term management with urethral Foley catheters.
Department of Urology, Nippon Medical School, Musashi Kosugi Hospital, Kanagawa, Japan; Department of Urology, Kitamurayama Hospital, Yamagata, Japan.
Ryoji
R
Kimata
Kaoru
K
Nemoto
Yuji
Y
Tomita
Ryo
R
Takahashi
Tsutomu
T
Hamasaki
Yukihiro
Y
Kondo
D000368:Aged; D000369:Aged, 80 and over; D020878:Device Removal / Q000295:instrumentation* / Q000379:methods*; D006358:Hot Temperature; D006801:Humans; D008297:Male; D011467:Prostate; D011474:Prosthesis Design; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014524:Urethral Obstruction / Q000628:therapy*; D014546:Urinary Catheterization
benign prostatic hyperplasia; thermoexpandable metallic prostate stent (Memokath); urethral obstruction