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Clinical utility of "blind placement" prostatic stent in patients with benign prostatic obstruction: a prospective
Kittinut Kijvikai1, Marleen van Dijk, Pilar Laguna Pes
1Department of Urology, University of Amsterdam Academic Medical Center, Amsterdam, The Netherlands.
Objectives:
To assess the efficacy and safety of two versions of a blind placement temporary prostatic stent in the treatment of patients with benign prostatic obstruction.
Methods:
Two versions of a prostatic stent (blind placement stent 1 [BPS-1] and BPS-2) were blindly inserted in an outpatient setting under local anesthesia. An assessment of voiding function, symptom scores, and complications was performed at baseline, directly after stent insertion, and at 14 and 28 days after stent placement.
Results:
A total of 55 men were enrolled in the trial. Most stents of both types were successfully placed. Spontaneous voiding was achieved in all patients immediately after stent insertion, with improvements in voiding parameters and symptom scores. In patients with the BPS-1, migration occurred in 85%. In patients with the BPS-2, migration occurred in 5%. The median indwelling time of the stent was 16 and 38 days for the BPS-1 and BPS-2, respectively. Removal was successful in all but 1 case (BPS-2).
Conclusions:
The BPS-1 is not suitable for clinical practice because of the significantly high migration rate. The bulbar segment of the BPS-2 can prevent stent migration. However, patients experienced significant discomfort after insertion of the BPS-2. The voiding parameters and symptom scores of the BPS-2 were not significantly improved. Therefore, the BPS-2 is also not useful for clinical practice. Additional adjustment in the design of the BPS is needed to overcome these problems.