Benign prostatic hypertrophy: treatment with a metallic stent

Machan, Lindsay; Jäger, Hans Rolf; Adam, Andreas; Gill, Kiren; Williams, Gordon R.; Allison, D J

doi:10.2214/ajr.153.4.779

Cited by 15 publications

(6 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The application of expandable metallic stents is of great clinical importance in the treatment of vascular6 and biliary stenosis 7, 8. It has been used for benign prostatic hyperplasia9 and urethral strictures10 with poor results. The use of such stents in the treatment of malignant and recurrent benign ureteral obstruction has been limited to experimental studies.…”

Section: Discussionmentioning

confidence: 99%

Ni‐Cr‐Co alloy ureteral stent: Scanning electron microscopy and elemental analysis characterization after long‐term indwelling

2010

View full text Add to dashboard Cite

We report the first preliminary study on metal-alloy ureteral stent after long indwelling times. The aim is to analyze by physical-chemical characterization of the stent after use and to evaluate the material performance in this human in vivo case study. Six Resonance metallic stents (Cook Ireland) were inserted in six patients for 6, 10, 11, 12, 24, and 36 months. The stents were then collected and studied by Field Emission Scanning Electron Microscopy (FESEM) and Energy Dispersive Spectroscopy (EDS), gaining information about the metal stent surface and the amount and nature of the formed encrustation. The stents were all draining adequately, despite the presence of the bacterial biofilm layer in all stents. This layer was more dense and compact as the indwelling time increased. Some slight precipitation of inorganic compounds, such as brushite and calcium oxalate was observed. No epithelial tissue in growth was recorded. These preliminary results with Resonance metallic ureteral stents suggest the feasibility of a long-term approach in patients with chronic ureteral obstruction. The durability of the metal stent, the lack of epithelial tissue ingrowths and limited pain or discomfort to patients were proven over long time periods. The long-term use of these stents is therefore feasible, avoiding the continuous exchange of the stent, decreasing hospital costs and increasing the quality of life of patients affected by malignant pelvic tumors.

show abstract

Section: Discussionmentioning

confidence: 99%

Ni‐Cr‐Co alloy ureteral stent: Scanning electron microscopy and elemental analysis characterization after long‐term indwelling

2010

View full text Add to dashboard Cite

show abstract

“…Gillams et al [ 7] described woven stainless‐steel stents of 9–14 F which were moderately successful and subsequently used in vascular surgery. Early experience in the urinary tract was in the prostatic urethra, with stents made from stainless‐steel [ 8, 9]. Encrustation and urothelial hyperplasia develop rapidly around these devices [ 10]; incorporation of these stents into the urothelium makes removal difficult, a feature substantiated by in vitro studies [ 10].…”

Section: Discussionmentioning

confidence: 99%

A new thermo‐expandable shape‐memory nickel‐titanium alloy stent for the management of ureteric strictures

Kulkarni¹,

Bellamy

1999

BJU International

View full text Add to dashboard Cite

Early experience with this new stent is very encouraging. All patients have maintained satisfactory decompression of their upper tracts with no need for repeated hospitalization for stent changes. There have been no untoward side-effects so far. This stent appears to have a valuable place in the long-term management of ureteric strictures; it is probably most suited for malignant ureteric obstruction. It should be considered in the management of selected benign strictures that require long-term JJ stenting.

show abstract

“…Two of the most important improvements with the present technique are the choice of optimum stent length and the precise placing of the stent, both pivotal factors contributing to successful stenting. In addition, the present technique does not require lumbar anaesthesia, endoscopy or X‐ray fluoroscopy equipment, making stent insertion simpler and less invasive than the conventional method using endoscopy and/or fluoroscopy [2,6,7]. The less‐invasive features of the technique are advantageous, particularly for high‐risk patients.…”

Section: Advantages and Disadvantagesmentioning

confidence: 99%

Precise and simple placement of a prostatic stent under real‐time transrectal ultrasonography monitoring

et al. 2003

View full text Add to dashboard Cite

Memokath stent is made from a nickel and titanium alloy which has a 'shape memory' feature; it softens at <10 ∞ C but regains its original shape when warmed to 50 ∞ C, and is therefore easy to insert and remove, unlike meshed stents [6]. Also its titanium component has been reported to minimize tissue inflammatory reaction and to prevent tissue ingrowth [7]. These features offer the potential for these stents to be adopted for long-term use, especially in high-risk patients with BOO.Two major issues influencing successful stenting are the choice of stent length and the precise placement of the stent. However, in the setting of the conventional technique for inserting prostatic stents using endoscopy and/or fluoroscopy, these issues have largely depended on the operator's experience. We therefore developed a precise and simplified method of inserting prostatic stents using real-time TRUS monitoring. METHODWith the patient in the lithotomy position, the posterior urethra from the bladder neck to the bulbar urethra is visualized in a midline sagittal TRUS image ( Fig. 1). Retrograde injection of 10-15 mL of lidocaine gel from the urethral meatus not only enhances urethral visibility (Fig. 1a) but also reduces the discomfort accompanying stent insertion. The length of stent was determined from the distance between the bladder neck and the sphincter, measured on the midline sagittal TRUS image (Fig. 1a). To fix the proximal end of the Memokath® stent on a flexible applicator sheath, a 10 F balloon catheter inserted into the applicator is inflated with ª 1 mL of water (Fig. 1e). As shown in Fig. 1b,c, the stent/applicator/balloon catheter assembly is gently advanced into the urethra under real-time TRUS monitoring until the balloon is just in the bladder. The precise positioning of the stent (the proximal end protruding 2-3 mm into the bladder from the bladder neck and the distal end between the verumontanum and the external urethral sphincter) is readily achievable under realtime TRUS monitoring. Sterile 50 ∞ C saline is then injected through a port of the applicator; the lower end of the stent expands and locks into place (Fig. 1d). The balloon catheter is deflated and removed, and the applicator then removed gently. Spontaneous voiding occurs immediately after stenting.In the past 2 years we have used this technique in 18 patients (mean age 80 years, range 65-92) with urinary retention caused by BOO. All were high-risk patients unfit for surgery, as they had cardiovascular and/or cerebrovascular complications. Stenting was successful and the subsequent course uneventful in all 18 attempts. All patients were able to void immediately after stent INDICATIONProstatic stenting is a useful alternative treatment for urinary retention caused by BOO, especially in high-risk patients unfit for surgery. Although early experience in urinary tract stenting was with stents made from stainless steel [1,2], encrustation and urothelial hyperplasia develop rapidly around these devices, and incorporating these stents into the urothel...

show abstract

Benign prostatic hypertrophy: treatment with a metallic stent

Cited by 15 publications

References 2 publications

Ni‐Cr‐Co alloy ureteral stent: Scanning electron microscopy and elemental analysis characterization after long‐term indwelling

Ni‐Cr‐Co alloy ureteral stent: Scanning electron microscopy and elemental analysis characterization after long‐term indwelling

A new thermo‐expandable shape‐memory nickel‐titanium alloy stent for the management of ureteric strictures

Precise and simple placement of a prostatic stent under real‐time transrectal ultrasonography monitoring

Contact Info

Product

Resources

About