[Role of urodynamics in implantation of prostatic stents]

Recent anxieties about the risk of prostate surgery in elderly and unfit patients have generated considerable interest in a number of new permanent prostatic stents. The prostatic Urolume Wallstent was positioned in 34 patients affected by BPH, all with acute or chronic retention of urine, most of whom were unfit for conventional prostatic surgery; the average follow-up is 14 months (range 9-24 months). The stents were inserted with the patients under local or regional anesthesia. 14 patients had prevalent irritative pre-retention symptoms, while in 18 patients obstructive symptoms were dominant; in the remaining 2 patients symptoms were minimal. Cystometry was performed in 29 patients before treatment for evaluation of detrusor activity. Following stent insertion, 31 patients were able to empty satisfactorily, while the remaining 3 patients presented chronic retention because of detrusor failure, evidenced before treatment. Most patients experienced frequency and urgency for several months (90% of 14 patients with pre-treatment irritative symptoms; 25% of the other 20 patients). No incrustation occurred, no serious urosepsis was registered. In 3 patients we need to put in a second stent. In the first weeks, 4 stents were removed for dislocation and then replaced endoscopically without difficulty or damage to the urethra. After 6 months, other 5 stents were definitively removed because of persistent unbearable irritative symptoms with poor quality of life (all these patients had severe pre-operative detrusor overactivity).(ABSTRACT TRUNCATED AT 250 WORDS)