A prostatic stent is a

stent In medicine, a stent is a metal or plastic tube inserted into the lumen of an anatomic vessel or duct to keep the passageway open, and stenting is the placement of a stent. A wide variety of stents are used for different purposes, from expandab ...

used to keep open the

male urethra The urethra (from Greek οὐρήθρα – ''ourḗthrā'') is a tube that connects the urinary bladder to the urinary meatus for the removal of urine from the body of both females and males. In human females and other primates, the urethra ...

and allow the passing of urine in cases of prostatic obstruction and

lower urinary tract symptoms Lower urinary tract symptoms (LUTS) refer to a group of clinical symptoms involving the bladder, urinary sphincter, urethra and, in men, the prostate. The term is more commonly applied to men—over 40% of older men are afected—but lower urin ...

(LUTS). Prostatic obstruction is a common condition with a variety of causes.

Benign prostatic hyperplasia Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, inability to urinate, or loss o ...

(BPH) is the most common cause, but obstruction may also occur acutely after treatment for BPH such as transurethral needle ablation of the prostate (TUNA),

transurethral resection of the prostate Transurethral resection of the prostate (commonly known as a TURP, plural TURPs, and rarely as a transurethral prostatic resection, TUPR) is a urological operation. It is used to treat benign prostatic hyperplasia (BPH). As the name indicates, ...

(TURP), transurethral microwave thermotherapy (TUMT),

prostate cancer Prostate cancer is cancer of the prostate. Prostate cancer is the second most common cancerous tumor worldwide and is the fifth leading cause of cancer-related mortality among men. The prostate is a gland in the male reproductive system that sur ...

or after

radiation therapy Radiation therapy or radiotherapy, often abbreviated RT, RTx, or XRT, is a therapy using ionizing radiation, generally provided as part of cancer treatment to control or kill malignant cells and normally delivered by a linear accelerator. Radi ...

Classification

There are two types of prostatic stent: temporary and permanent. Although a permanent prostatic stent is not a medical treatment, it falls under the classification of a surgical procedure. Placement of a permanent prostatic stent is carried out as an outpatient treatment under local, topical or spinal anesthesia and usually takes about 15–30 minutes. A temporary prostatic stent can be inserted in a similar manner to a

Foley catheter In urology, a Foley catheter (named for Frederic Foley, who produced the original design in 1929) is a flexible tube that a clinician passes through the urethra and into the bladder to drain urine. It is the most common type of indwelling urinar ...

, requiring only topical anesthesia.

Permanent stents

Advantages

* They can be placed in less than 15 minutes under regional anesthesia. * Bleeding during and after surgery is minimal. * The patient can be discharged the same day.

Disadvantages

* They may cause increased urination and limited incontinence. * They may cause mild discomfort * They can become dislodged, leading to urinary obstruction or total incontinence. * They can become infected and can be very difficult to remove. * Their fixed diameter limits subsequent endoscopic surgical options.

Temporary stents

Advantages

* They can be placed in less than 15 minutes in a manner similar to Foley catheter placement. * They can be easily removed, also in a manner similar to Foley catheter removal. * They allow the patient to retain volitional voiding. * Patients prefer a temporary stent to Foley catheter use.

Disadvantages

* A temporary stent will not provide voiding function if the patient does not have a working bladder and external sphincter. * The stent may cause mild discomfort. * They may cause urinary frequency which usually subsides after the first 78 hours. * If the stent is not sized correctly or placed correctly, the patient may experience urinary retention or slight incontinence until the problem is corrected.

Society

Legal approval in the
United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territo ...

At the present time, there is one temporary prostatic stent that has received

U.S. Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food s ...

(FDA) approval. The Spanner temporary prostatic stent maintains urine flow and allows natural voluntary urination. The prostatic stent is a completely internal device and can be inserted and removed as easily as a

. It permits normal bladder and sphincter functioning and can be worn comfortably by patients. The temporary prostatic stent is typically used to help patients maintain urine flow after procedures that cause prostatic swelling, such as brachytherapy, cryotherapy, TUMT, TURP. It has also become an effective differential diagnostic tool for identifying poor bladder function separate from prostatic obstruction.

Research

Permanent stents are often metal coils, which are inserted into the male urethra. The braided mesh is designed to expand radially, applying constant gentle pressure to hold open the sections of the urethra that obstruct the flow of urine. The open, diamond-shape cell design of the stent allows the stent to eventually become embedded in the urethra, thus minimizing the risk for encrustation and migration. Permanent stents are used to relieve urinary obstructions secondary to

benign prostatic hyperplasia Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, inability to urinate, or loss o ...

(BPH), recurrent bulbar

urethral stricture A urethral stricture is a narrowing of the urethra, the tube connected to the bladder that allows the passing of urine. The narrowing reduces the flow of urine and makes it more difficult or even painful to empty the bladder. Urethral stricture i ...

(RBUS), or

detrusor The detrusor muscle, also detrusor urinae muscle, muscularis propria of the urinary bladder and (less precise) muscularis propria, is smooth muscle found in the wall of the bladder. The detrusor muscle remains relaxed to allow the bladder to st ...

external sphincter dyssynergia (DESD). The main motive for removal of permanent stents is worsening of symptoms even with device fitted. Other reasons have been migration, clot retention,

hematuria Hematuria or haematuria is defined as the presence of blood or red blood cells in the urine. “Gross hematuria” occurs when urine appears red, brown, or tea-colored due to the presence of blood. Hematuria may also be subtle and only detectable ...

, and

urinary retention Urinary retention is an inability to completely empty the bladder. Onset can be sudden or gradual. When of sudden onset, symptoms include an inability to urinate and lower abdominal pain. When of gradual onset, symptoms may include loss of bladd ...

. The only FDA approved permanent stent is the Urolume. Usually, permanent stents are used only for men who are unwilling or unable to take medications or who are reluctant or unable to have surgery. Most doctors do not consider permanent stents a viable long-term treatment for most men.Enlarged prostate (BPH) guide - MayoClinic.com
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References

External links

{{Medical resources , DiseasesDB = 10797 , ICD10 = {{ICD10, N, 40, , n, 40 , ICD9 = {{ICD9, 600 , ICDO = , OMIM = , MedlinePlus = , eMedicineSubj = med , eMedicineTopic = 1919 , MeshID = Urologic procedures Prostatic procedures

Classification

Permanent stents

Advantages

Disadvantages

Temporary stents

Advantages

Disadvantages

Society

Legal approval in the United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territo ...

Research

See also

References

External links

Legal approval in the
United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territo ...