Purpose: To evaluate the thermo-expandable prostatic stent (Memokath) in patients presenting in acute urinary retention (AUR) secondary to benign prostatic hyperplasia(BPH).
Materials and Methods: From October 2007 to August 2009, 40 patients at high risk anaesthesiologically who had developed AUR secondary to BPH underwent Memokath stent insertion. The stents were inserted in an outpatient setting under local anaesthesia or brief regional block. The patients were evaluated by physical examination, digital rectal examination (DRE), symptom evaluation using the International Prostate Symptom Score Questionnaire (IPSS), uroflowmetry, and postvoid residual (PVR) urine volume measurement. The patients were evaluated at baseline and at 2 weeks, 1, 3 , 6,and 12 months after stent placement.
Results: Stents were successfully inserted in all patients. Spontaneous voiding was achieved in all patients. The peak urinary flow rate (Qmax), PVR urine volume, and IPSS and quality of life (QOL) score were significantly improved after procedure and continued to improve during subsequent follow-up. At 12 month, IPSS had improved from 26.1 (range18-35) to 14.8 (range 3-28; P = 0.031), and QOL score had improved from 5.2 (range 2-6) to 2.1 (range 0-4); P = 0.04. The PVR urine volume had decreased from 570 ml (range 420-710) to 79 ml (range 25-330); P = 0.002. The Qmax increased from 0 to 12.3 ml; P <0.0001.The main complications were urge incontinence (15%)and stent migration (7.5%).The main reason for removal of the stent was worsening of symptoms(5%).
Conclusions: Memokath prostatic stent represents a safe and effective treatment option for patients with BPH presenting with AUR .It has low morbidity and provides immediate symptoms and voiding improvement.
Key words: Memokath , Acute urinary retention, Benign prostatic hyperplasia , Urethra.
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