A MODIFIED PROSTATIC UROLUME-WALLSTENT FOR HEALTHY PATIENTS WITH SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA - A EUROPEAN MULTICENTER STUDY

Objectives. This European multicenter study was aimed to assess the cl inical reliability of a modified prostatic UroLume Wallstent (American Medical System, Minnetonka, MN) in the treatment of 135 healthy patie nts with symptomatic benign prostatic hyperplasia. Methods. Ninety-one patients who were obstructed but still voiding spontaneously and 44 p atients who had an indwelling catheter were treated by placement of a modified stent. Results. A significant improvement in mean peak flow r ates and residual urine volumes was maintained throughout follow-up. B oth obstructive and irritative voiding symptoms were significantly imp roved after placement of the stent, although a greater amelioration wa s seen in obstructive symptoms. The rate of patients reporting erectio ns increased after stent insertion. Eighty percent of sexually active patients reported the maintenance of antegrade ejaculation postoperati vely. A greater than 80% epithelialization of the stent was seen in 28 patients (100%) examined at the 18-month follow-up. Long-term complic ations were seen in 51 patients (38%). Twenty-one of these patients ha d the stent removed due to intractable detrusor instability, stent enc rustation, stent migration, or persistence of obstruction due to promi nent median lobe, understenting, or severe hyperplasia of the epitheli um of the prostatic urethra. In 6 of them another stent was reimplante d while the others were treated surgically. Conclusions. Although this modified stent was abandoned due to an unacceptable rate of complicat ions, this study demonstrates that bladder outlet obstruction in healt hy patients with benign prostatic hyperplasia can be successfully reli eved by the placement of a UroLume Wallstent.