Self-expandable metallic stents in high-risk patients with benign prostatic hyperplasia: long-term follow-up.

Abstract

To evaluate the long-term clinical utility of self-expandable metallic Z stents in benign prostatic hyperplasia (BPH). Under fluoroscopic guidance, 14 multiple-connected Z stents (10 mm in diameter fully expanded, 30-60 mm in length) were placed in 13 patients with bladder obstruction from BPH and high operative risks. The stents were placed in the prostatic urethra with 2-20-mm protrusion into the urinary bladder in six patients (group A) and entirely within the prostatic urethra in seven patients (group B). Eleven of 13 patients could void immediately, and the other two patients with atonic bladder voided within 8 weeks. Maximum urine flow rates just after stent placement were 8-27 mL/sec. Two patients died of unrelated causes within 2 months. During the follow-up period (mean, 37 months) in the other 11 patients, all patients in group A but none in group B underwent surgery owing to stone formation where the stent protruded into the bladder. Expandable Z stents are effective in patients with BPH but should not protrude into the urinary bladder because of stone formation.