PROSTATIC UROLUME WALLSTENT FOR BENIGN PROSTATIC HYPERPLASIA PATIENTSAT POOR OPERATIVE RISK - CLINICAL, UROFLOWMETRIC AND ULTRASONOGRAPHICPATTERNS

The prostatic UroLume Wallstent was positioned in 30 poor operative r isk patients with bladder outlet obstruction due to benign prostatic h yperplasia. Preoperatively, 12 patients (40%) could still void spontan eously (group 1), while 18 (60%) had an indwelling catheter (group 2). Preoperative and postoperative assessment included scoring of subject ive symptoms, physical examination, uroflowmetry with maximum flow nom ogram, transrectal ultrasonography of the prostate, determination of r esidual urine volume and cystourethroscopy. All but 1 patient could vo id spontaneously after insertion of the stent. In group 1 preoperative and 1-year followup mean (plus or minus standard error) peak flow rat es were 8.0 +/- 0.7 ml. per second and 15.8 +/- 1.8 ml. per second, re spectively (p < 0.01), the mean residual urine volumes were 127 +/- 27 ml. and 38 +/- 11 ml. (p < 0.05), respectively, and the mean maximum flow nomograms (plus or minus standard deviation) were -2.6 +/- 0.1 an d -1.4 +/- 0.4, respectively. In group 2 the 1-year followup mean peak flow rate, residual urine volume and maximum flow nomogram were 13.2 +/- 0.8 ml. per second (standard error), 32 +/- 14 ml. (standard error ) and -1.5 +/- 0.1 (standard deviation), respectively. According to th e maximum flow nomogram values all patients were nonobstructed postope ratively. At 1 year the stent was completely covered by prostatic epit helium in 90% of the patients, while in the remainder it was still par tially visible at urethroscopy. Transrectal ultrasonography had an ess ential role in patient followup by accurately assessing the position o f the stent. Placement of this prostatic stent is safe and effective f or selected benign prostatic hyperplasia patients who cannot undergo s urgical treatment due to poor operative risk.