Exime prostatic stent in acute and chronic urinary retention.

Abstract

Purpose: The Exime prostatic stent, a silicone-based device designed for temporary urinary retention management, offers an alternative to indwelling urethral catheters (IUCs), allowing spontaneous voiding. This study aimed to compare the efficacy and safety of the Exime device with IUCs in patients with urinary retention due to benign prostatic obstruction (BPO).

Methods: This retrospective study included 43 patients from 2020 to 2024 with failed trial without catheter (TWOC) following acute urinary retention (AUR) secondary to BPO, prostate volume ≤ 120 mL, and intravesical prostatic protrusion < 5 mm. The stent was inserted under local anesthesia as an outpatient procedure.

Primary endpoint: effectiveness in restoring urinary flow. Secondary endpoints: complications, patient preferences, and comparisons with IUCs.

Results: Median patient age was 86 years (IQR 78-90); median prostate volume was 45 mL (IQR 40-61). The stent was successfully inserted in 42 patients (98%), with all achieving spontaneous voiding. Median post-void residual volume was 45 mL (IQR 38-73), and 70% retained the stent for ≥ 4 weeks. Complications included obstruction (14%), infection (9%), and migration (7%). Compared to IUCs, the Exime stent reduced symptomatic urinary tract infections (9% vs. 40%, p = 0.03), bladder spasms (16% vs. 84%, p < 0.001), and urinary leakage (0% vs. 30%, p < 0.001). Patients reported lower pain (VAS 2 vs. 8, p < 0.001) and higher satisfaction (VAS 8 vs. 1, p < 0.001).

Conclusion: The Exime stent effectively managed urinary retention with fewer complications and higher patient satisfaction compared to IUCs.