Outcomes of the novel EXIME prostate stent: initial experience in a South African setting

Urinary retention due to Benign Prostatic Hyperplasia (BPH) is a frequent and serious urological emergency. This study evaluated the efficacy and clinical outcomes of the EXIME temporary prostatic stent as an alternative to traditional catheterisation.

A prospective study including 50 male patients presenting with BPH-related urinary retention or those awaiting definitive surgery was performed. The EXIME stent was inserted as an outpatient for a one-month indwelling period. Primary endpoints included voiding efficacy and ease of use. Secondary outcomes assessed sexual function restoration, pain and bacterial colonisation rates.

Spontaneous voiding was achieved in all 50 patients with a median maximum flow rate (Qmax) of 17.8 ml/s [IQR 12.9-21.7] and a median post-void residual (PVR) of 20 ml [IQR 10-37]. A significant restoration of sexual activity was observed, with a resumption rate of 88% among previously sexually active men (p < 0.001). Surrogate markers for bacterial colonisation improved with dipstick nitrite positivity dropping from 26% pre-insertion to 0% at removal (p < 0.001). Procedurally, 90% of insertions were graded as extremely easy to easy (VAS 1-3) and 84% of patients reported only minimal to uncomfortable pain (VAS 1-3). The failure rate was 4% with only two early removals documented.

This study represents the first clinical experience on this novel innovation on the continent of Africa, demonstrating a safe, effective, and well-tolerated alternative to traditional catheterization by providing immediate symptom relief and improved outcomes regarding sexual function and bacterial colonisation thus supporting its use in the management of BPH-related urinary retention.