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(R), Bard/Angiomed, Karlsruhe, Germany) in hig h-risk patients with advanced prostatic carcinoma and subvesical obstr uction. Patients and methods The study included 35 patients (mean age 75.3 years, range 53-89) with advanced prostatic carcinoma and persist ent subvesical obstruction despite androgen ablation. Because of serio us concurrent diseases, 49% of these patients were classified as Ameri can Society of Anesthesiologists (ASA) grade 3 and 51% as ASA grade 4, The patients were treated using the Memotherm(R) stent, a thermosensi tive Nitinol(TM) mesh stent, The outcome was assessed by measuring voi ding 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 impro vement 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. Conclusion For high-risk patients with subvesical obstruction caused by prostatic ca rcinoma, the insertion of a permanent metal stent system offers a usef ul alternative treatment to transurethral resection.