COMPARISON BETWEEN FIRST-GENERATION (FIXED-CALIBER) AND 2ND-GENERATION (SELF-EXPANDING, LARGE CALIBER) TEMPORARY PROSTATIC STENTS

In this study our aim was to compare a first-generation intraprostatic stent (Prostakath) with a second-generation one (ProstaCoil) in patie nts with prostatic obstruction. The comparison was made in terms of ea se of insertion, need for repositioning, migration, infection, stone f ormation and length of time in place. One hundred and seventeen patien ts with an age range of 52-94 years were included in this study. Forty -nine of the patients were treated with gold-plated stainless-steel-ma de stent (Prostakath) inserted under sonographic and 68 of the patient s were treated with a nitinol-made stent (ProstaCoil) inserted under f luoroscopic guidance. Indications for stent insertion were similar for both groups. We found that immediate correct positioning was 83% for the Prostakath and 100% for the ProstaCoil. In 42% of the cases the Pr ostakath necessitated later repositioning because of partial migration and in 12% of the cases removal because of complete migration into th e bladder or the anterior urethra. No migration was observed with the ProstaCoil. In 10% of these cases the Prostakath could not be inserted because of the instability of the stent. Due to its larger caliber th e second-generation stent caused more transient irritative symptoms. N o difference was found in stent-induced infections (10% for all stents ). Encrustations were found in 40% of the patients at 1 year with the Prostakath, but in 30% with the ProstaCoil at 2 years. Maximal indwell ing time was 12 months with the Prostakath and 36 months with the Pros taCoil. We conclude that the second-generation stent was more advantag eous because of its larger caliber allowing catheterization and endosc opic examinations, more flexibility and much longer indwelling time.