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The intraprostatic spiral: clinical results in 150 consecutive patients
J Nordling1, H Ovesen, A L Poulsen
1Department of Urology, Herlev Hospital, University of Copenhagen, Denmark.
Abstract:
The clinical results of treatment of infravesical prostatic obstruction with an intraurethral coil in 150 consecutive patients are reported. A total of 80 patients had urinary retention and 70 had severe prostatism. Median observation time was 8.2 months, with a range of 0 to 40 months. In 75 patients the spiral was removed after a median of 4 months (range 0 to 30 months) because of planned prostatectomy in 17, urinary retention in 16, incontinence in 10, local discomfort in 7, no symptomatic improvement in 13 and causes not related to the spiral (stroke and so forth) in 7. Migration occurred 55 times in 42 patients but this only led to coil removal in 5. A total of 23 patients died with the coil in situ. Voiding symptoms improved considerably in the majority of the patients. Approximately two-thirds of the patients had no or few symptoms, while a fourth had moderate symptoms, leaving only approximately 10% with severe prostatism. Chronic bacteriuria was noted in 52 patients but was not a clinical problem. Calcification on the top and inside of the coil was noted mainly after long-term treatment, and probably necessitated exchange of the coil after 2 to 3 years. We conclude that the prostatic spiral is a useful alternative to an indwelling catheter. However, life-long followup is necessary in most patients.
Insights
The intraurethral prostatic spiral effectively treats infravesical prostatic obstruction, improving voiding symptoms for most patients. This device offers a useful alternative to indwelling catheters, though long-term follow-up is recommended.
Area of Science:
- Urology
- Medical Devices
Background:
- Infravesical prostatic obstruction is a common condition causing significant voiding difficulties.
- Indwelling catheters are a common treatment but can lead to complications.
Purpose of the Study:
- To evaluate the clinical outcomes of treating infravesical prostatic obstruction using an intraurethral coil.
- To assess the safety and efficacy of the prostatic spiral as an alternative to indwelling catheters.
Main Methods:
- A prospective study of 150 consecutive patients with infravesical prostatic obstruction.
- Patients received an intraurethral coil, with follow-up data collected on symptom improvement, complications, and device removal.
- Median observation time was 8.2 months.
Main Results:
- Voiding symptoms improved significantly in the majority of patients; two-thirds experienced no or few symptoms.
- Coil migration occurred in 42 patients, but only required removal in 5.
- Chronic bacteriuria was noted in 52 patients but was not clinically problematic. Calcification may necessitate coil exchange after 2-3 years.
Conclusions:
- The intraurethral prostatic spiral is a viable alternative to indwelling catheters for managing infravesical prostatic obstruction.
- While generally safe and effective, long-term patient follow-up is essential.
- Potential long-term calcification may require device replacement.