The 12-year outcome analysis of an endourethral wallstent for treating benign prostatic hyperplasia

To evaluate the long-term results of using the Urolume(TM) endourethral prosthesis (American Medical Systems, Minnetonka, MN, USA) for managing benign prostatic hyperplasia (BPH), an alternative minimally invasive option.

Sixty-two patients with moderate/severe lower urinary tract symptoms secondary to BPH were treated with the Urolume stent by one surgeon (J.H.P.). They were followed up at 12 weeks, 6 months and then yearly. Data recorded before and after treatment included symptom scoring, peak urinary flow rate (PFR) and postvoid residual volume (PVR). A one-way anova was used to compare baseline and the 5- and 12-year follow-up data.

Twenty-two and 11 patients completed the 5- and 12-year follow-up, respectively. Twenty-one (34%) patients died with the stent in situ from causes unrelated to BPH and Urolume insertion. Twenty-nine (47%) stents were removed; 18 in the first 2 years, seven at 3-5 years and four at 9-10 years. Early stent explantation was primarily a result of poor case selection, or stent malposition/migration. Four stents were removed because the patient was dissatisfied. Late stent explantation was for symptom progression. At 5 years, the symptom score and PFR were 6.82 an 11.7 mL/s, respectively, compared with 20.4 and 9 mL/s at basleine (P < 0.05); at 12 years, the symptom score, PFR and PVR were 10.82, 11.5 mL/s and 80 mL, respectively. The mean quality of life score was 2 and no patient opted for any further treatment.

The Urolume wallstent is a safe treatment for BPH, in selected patients. Careful case selection and experience is mandatory. This stent can provide the urologist with an alternative along with other minimally invasive treatments for men with BPH at high risk of requiring transurethral resection.