[Long-term temporary prosthesis in prostatic obstruction. ProstaCoil, an expanding, self-fixating implant of large...

The spiral metallic stent for insertion into the prostatic urethra developed by Fabian a decade ago, and its various modifications have a fixed external caliber of up to 21F and does not allow passage of instruments larger than 5-6F through it. Thus, they cannot be used in patients who need frequent trans-urethral manipulations. Since all temporary prostatic stents, in the long term develop incrustations they have to be changed once a year, or earlier, if they become occluded by stone formation. Permanent stents cannot be used in patients who are temporarily unfit for surgery because their removal necessitate traumatic manipulations. In order to overcome these disadvantages, a new large caliber, self-expanding and self-retaining intra-prostatic stent was developed (ProstaCoil). This stent is inserted under fluoroscopic guidance using topical anaesthesia. During the last 36 months the ProstaCoil was inserted into 65 patients suffering from complete prostatic obstruction due to BPH. Follow-up of our patients was 3-28 months (mean 16 months). Forty-eight patients could void either immediately or within 48 hours after insertion of the stent. Thirty patients underwent TURP or open prostatectomy 3-12 months after insertion of the stent. In all these cases the stent was removed easily before surgery. Only in 1 case the stent was removed because of severe urge incontinence. Seven patients died during this period. Twenty-seven patients still are passing urine through their stents (the longest 32 months).