First experiences with the Spanner? temporary prostatic stent for prostatic urethral obstruction

摘要

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.