Are stents still a useful therapy for benign prostatic hyperplasia?

The use of an endoprosthesis to maintain lumenal patency is a well-established concept used in a variety of surgical settings, including cardiovascular and gastrointestinal pathologies. However, the utility of self-retaining endoprosthetics and their application in prostatic pathology and benign prostatic hyperplasia is not as clear. This report reviews recent developments in the management of symptomatic benign prostatic hyperplasia, particularly the current role of intraprostatic stenting in the advent of other minimally invasive therapies such as laser prostatectomy.

Over the past 5 years, urology has witnessed the proliferation of minimally invasive surgical therapies for benign prostatic hyperplasia. These interventions have enabled the urologist to treat a problem whose management was once limited to medical therapy, transurethral resection of the prostate, or open, relatively morbid surgery. The role of stents as an intermediary in cases of treatment failure, or as definitive therapy for benign prostatic hyperplasia and its associated problems is still not clear, when compared with newer, minimally invasive options. Current literature on stents is relatively sparse. However recent studies demonstrate that permanent and temporary prostatic urethral stenting are effective in relieving obstruction and urinary retention. Nevertheless larger controlled clinical studies are needed to demonstrate the real value of this intervention.

Prostatic stenting has a definite role in the management of benign prostatic hypertrophy, but stents must be used with caution because complications are still relatively common, and their true efficacy and utility in the urological setting has not been determined.