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

PURPOSE: To evaluate the long-term clinical utility of self-expandable metallic Z stents in benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: 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). RESULTS: 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. CONCLUSION: Expandable Z stents are effective in patients with BPH but should not protrude into the urinary bladder because of stone formation.