[Biodegradable prostatic stents in treating patients with prostatic enlargement]

A total of 39 patients with prostatic hyperplasia (PH) admitted to the urological clinic of I. M. Sechenov Moscow Medical Academy from 1999 have been inserted a biodegradable catheter stent (BCS). Such stents degrade spontaneously to microfragments and come away with urine 4-12 months after catheterization. BCS were used in PH patients with marked urination disorders due to urethral compression by hyperplastic prostate in whom adenomectomy was contraindicated. BCS was used for elimination of a suprapubic fistula in the urinary bladder of 19 PH patients with contraindications to adenomectomy. 5-7 days before catheterization the urinary bladder was drained 2 times a day to reduce pyoinflammatory process. The cystostomic fistula closed within 24 h in all the patients. Adequate urination recovered. Urethral inflammation persisted for 4-6 weeks. It was treated with antibiotics with effectiveness 89.5% (in 17 of 19 patients). Pyoinflammation persisted in two patients who developed uroliths destructed later at endoscopic pneumatic cystolithotripsy. Control examination 6 months after the stent insertion found that the stent had destructed with evacuation of the fragments. In two patients two large fragments were locked in the urethra provoking acute ischuria. The fragments were removed by the forceps and urination became normal. None of the patients needed recystostomy. 32 stented patients 6 and 12 months after stenting had adequate urination (mean Qmax--12.3 and 10.8 ml/s, respectively). Mean residual urine--32 and 37 ml. BCS improves treatment outcomes and quality of life of PH patients with contraindications to adenomectomy.