[Intraprostatic prostheses]

We evaluated the usefulness of the intraprostatic spiral prosthesis as an alternative to surgical treatment of benign prostatic hyperplasia (BPH) (40 cases), cancer of the prostate (7 cases), and cervico-prostatic sclerosis (2 cases). These 49 prostheses were placed in elderly patients (mean age 79 years) who had a long indwelling urethral catheter (mean 6.2 months) and were at high risk for surgery (ASA IV 83.6%). In 17% of the cases, placement of the prosthesis permitted performing curative surgery subsequently, once patient general condition had improved. Overall, good results were achieved in 63% (53 patients with BPH) of the cases who tolerated the long indwelling prosthesis well (mean 22 months). The results were assessed according to the quality of micturition (normal in 74.3%), correct placement of the stent (80%), no post-micturition residual volume (88.5%), and a flow rate of 6-12 ml/sec. (60%). Poor results (9 cases) owing to migration of the stent (7 cases) and/or complications: perforation of urethra (1 case), secondary stricture (1 case) and partial calcification of the prosthesis (1 case). The advantages and disadvantages of other currently utilized stents (Prostakath, Variospire, Wall-Stent, and Double Pezzer) are discussed.