LONG-TERM TEMPORARY STENTING OF PROSTATIC OBSTRUCTION USING A LARGE CALIBER, SELF-EXPANDING AND SELF-RETAINING COIL STENT - PROSTACOIL

The spiral metallic stent for insertion into the prostatic urethra dev eloped by Fabian a decade ago, and its various modifications have a fi xed external caliber of up to 21F and does not allow passage of intrum ents larger than 5-6F through it. Thus, they cannot be used in patient s who need frequent trans-urethral manipulations. Since all temporary prostatic stents, in the long term develop incrustations they have to be changed once a year, or earlier, if they become occluded by stone f ormation. Permanent stents cannot be used in patients who are temporar ily unfit for surgery because their removal necessitate traumatic mani pulations. In order to overcome these disadvantages, a new large calib er, self-expanding and self-retaining intra-prostatic stent was develo ped (ProstaCoil). This stent is inserted under fluoroscopic guidance u sing topical anaesthesia. During the last 36 months the ProstaCoil was inserted into 65 patients suffering from complete prostatic obstructi on due to BPH. Follow-up of our patients was 3-28 months (mean 16 mont hs). Forty-eight patients could void either immediately or within 48 h ours after insertion of the stent. Thirty patients underwent TURP or o pen prostatectomy 3-12 months after insertion of the stent. In all the se cases die stent was removed easily before surgery. Only in 1 case t he stent was removed because of severe urge incontinence. Seven patien ts died during this period. Twenty-seven patients still are passing ur ine through their stents (the longest 32 months).