Objectives: To assess the ease of insertion and removal of a temporary prostatic stent (the Spanner™) following the use of a prostatic urethral measuring device (the Surveyor™). Patients and Methods: Patients with bladder outflow obstruction or urinary retention awaiting definitive surgery were fully consented. Data were collected pre- and post-insertion and patients followed-up until definitively treated. Results: 16 patients had the Spanner inserted following use of the Surveyor. All insertions were uncomplicated. 14 patients were able to void satisfactorily immediately post-insertion with a mean Qmax of 15.0 ml/s and post-void residual of 51.3 ml. No symptomatic infection was reported. The stents stayed in situ for a median of 10 days. 12 stents were removed prematurely due to severe symptoms or retention. A total of 12 stents had to be removed endoscopically. Conclusions: The Spanner is easy to insert. Stent removal via the retrieval suture has been difficult necessitating the use of endoscopy in the majority of cases. Possible causes of stent failure include underestimation of the prostatic urethral length by the Surveyor leading to obstruction by apical prostatic tissue, excessive suture length between the stent and distal anchor permitting proximal migration or inadequate suture length leading to urinary incontinence. Further design modifications are suggested.

Keywords:
Prostate, Stent, Prostatic outflow obstruction
1.
Devonec M, Dahlstrand C: Temporary urethral stenting after high-energy transurethral microwave thermotherapy of the prostate. World J Urol 1998;16:120-123.
2.
De la Rosette JJ, Beerlage HP, Debruyne FM: Role of temporary stents in alternative treatment of benign prostatic hyperplasia. J Endourol 1997;11:467-472.
3.
Vicente J, Salvador J, Chéchile G: Spiral urethral prosthesis as an alternative to surgery in high risk patients with benign prostatic hyperplasia: prospective study. J Urol 1989;142:1504-1506.
4.
Gesenberg A, Sintermann R: Management of benign prostatic hyperplasia in high risk patients: long-term experience with the Memotherm stent. J Urol 1998;160:72-76.
5.
Badlani GH: Role of permanent stents. J Endourol 1997;11:473-475.
6.
Anjum MI, Chari R, Shetty A, Keen M, Palmer JH: Long-term clinical results and quality of life after insertion of a self-expanding flexible endourethral prosthesis. Br J Urol 1997;80:885-888.
7.
Pétas A, Isotalo T, Talja M, Tammela TL, Välimaa T, Törmälä P: A randomised study to evaluate the efficacy of a biodegradable stent in the prevention of postoperative urinary retention after interstitial laser coagulation of the prostate. Scand J Urol Nephrol 2000;34:262-266.
8.
Laaksovirta S, Isotalo T, Talja M, Välimaa T, Törmälä P, Tammela TLJ: Interstitial laser coagulation and biodegradable self-expandable, self-reinforced poly-L-lactic and poly-L-glycolic copolymer spiral stent in the treatment of benign prostatic enlargement. J Endourol 2002;16:311-315.
9.
Pétas A, Talja M, Tammela T, Taari K, Lehtoranta K, Välimaa T, et al: A randomized study to compare biodegradable self-reinforced polyglycolic acid spiral stents to suprapubic and indwelling catheters after visual laser ablation of the prostate. J Urol 1997;157:173-176.
10.
Traxer O, Anidjar M, Gaudez F, Saporta F, Daudon M, Cortesse A, et al: A new prostatic stent for the treatment of benign prostatic hyperplasia in high-risk patients. Eur Urol 2000;38:272-278.
11.
Isotalo T, Talja M, Hellström P, Perttilä I, Välimaa T, Törmälä P, et al: A double-blind, randomized, placebo-controlled pilot study to investigate the effects of finasteride combined with a biodegradable self-reinforced poly L-lactic acid spiral stent in patients with urinary retention caused by bladder outlet obstruction from benign prostatic hyperplasia. BJU Int 2001;88:30-34.
12.
Cooper K, Te AE, Kaplan SA: Long term safety and efficacy in 147 patients treated with prostate stents for benign prostatic hyperplasia: 12 year results. J Urol 2003;169:466.
13.
Dahlstrand C, Grundtman S, Pettersson S: High-energy transurethral microwave thermotherapy for large severely obstructing prostates and the use of biodegradable stents to avoid catheterization after treatment. Br J Urol 1997;79:907-909.
14.
Donnell RF: Urethral stents in benign prostate hyperplasia. Curr Urol Rep 2003;4:282-286.
15.
Cockett AT, Aso Y, Denis L, et al: Recommendations of the International Consensus Committee. 4. Treatment recommendations for benign prostatic hyperplasia (BPH). Proc 3rd Int Consultation on Benign Prostatic Hyperplasia, Monaco, 1995, pp 625-650.
16.
Yachia D: Temporary metal stents in bladder outflow obstruction. J Endourol 1997;11:459-465.
17.
Fabian KM: The intra-prostatic ‘partial catheter' (urological spiral). Urologe Ausg A 1980;19:236-238.
18.
Fabian KM: The interprostatic ‘partial catheter' (urologic spiral). Part II. Urologe Ausg A 1984;23:229-233.
19.
Nissenkorn I: The intraurethral catheter - three years of experience. Eur Urol 1993;24:27-30.
20.
Yachia D, Beyar M, Aridogan IA: A new, large calibre, self-expanding and self-retaining temporary intraprostatic stent (ProstaCoil) in the treatment of prostatic obstruction. Br J Urol 1994;74:47-49.
21.
Kijvikai K, Van Dijk M, Pes PL, Lertsithichai P, Wijkstra H, De la Rosette J: Clinical utility of ‘blind placement' prostatic stent in patients with benign prostatic obstruction: a prospective study. Urology 2006;68:1025-1030.
22.
Corica AP, Larson BT, Sagaz A, Corica AG, Larson TR: A novel temporary prostatic stent for the relief of prostatic urethral obstruction. BJU Int 2004;93:346-348.
23.
Miano R, Kim FJ, De Nunzio C, Mauriello A, Sansalone S, Vespasiani G, et al: Morphological evaluation of the male external urethral sphincter complex by transrectal ultrasound: feasibility study and potential clinical applications. Urol Int 2012;89:275-282.
24.
Grimsley SJS, Khan MH, Lennox E, Paterson PH: Experience with the Spanner prostatic stent in patients unfit for surgery: an observational study. J Endourol 2007;21:1093-1096.
25.
Henderson A, Laing RW, Langley SEM: A Spanner in the works: the use of a new temporary urethral stent to relieve bladder outflow obstruction after prostate brachytherapy. Brachytherapy 2002;1:211-218.
26.
Shore ND, Dineen MK, Saslawsky MJ, Lumerman JH, Corica AP: A temporary intraurethral prostatic stent relieves prostatic obstruction following transurethral microwave thermotherapy. J Urol 2007;177:1040-1046.
27.
Dineen MK, Shore ND, Lumerman JH, Saslawsky MJ, Corica AP: Use of a temporary prostatic stent after transurethral microwave thermotherapy reduced voiding symptoms and bother without exacerbating irritative symptoms. Urology 2008;71:873-877.
© 2013 S. Karger AG, Basel
2013
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