Thermo-expandable intraprostatic nitinol stents in the treatment of bladder outlet obstruction: a consecutive case series.

Abstract

Objective: In high-risk patients, prostatic stents may alleviate obstruction at the prostate level. Since 2020 we have used thermo-expandable intraprostatic nitinol stents. Here we document outcomes through the first years with the procedure.

Material and methods: We reviewed  patients who had undergone stent treatment between May 2020 and October 2023. Patient and procedural data, urinary symptoms, complications and side effects were recorded. Descriptive statistics were used to summarize outcomes and we evaluated predictors of success and complications using robust multiple regression analyses.

Results: We included 52 consecutive patients with a median age of 82 years (range 71-96) and a median Charlson Comorbidity Index of 6 (3-11). Forty-seven men used indwelling catheters, two used clean intermittent catheterization, and three had severe lower urinary tract symptoms. Stents were placed under general anesthesia, sedation, and local anesthesia in 39, 4, and 9 men, respectively. The median treatment time was 14 min (range 8-40). One complication, in the form of an infection requiring IV antibiotics, occurred. Subsequently, 45 men (87%) were able to void spontaneously without bothersome symptoms. After a median of 11 (2-44) months, 8 men had their stents removed due to recurring symptoms. This gives an overall success rate of 37/52 patients (71%). No predictors of success or complications were identified.

Conclusions: Thermo-expandable intraprostatic nitinol stents demonstrate a high success rate with a low risk of complications and may serve as an alternative to permanent or intermittent catheterization for men who are unable or unwilling to undergo flow-improving surgery.