2003, Number 5
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Gac Med Mex 2003; 139 (5)
Use of UroLume as an Alternative in Reocurring Bulbar Urethra Stenosis and Obstructive Prostatic Hyperplasia in High-Risk Surgery Patients
Serrano-Brambila EA, Camacho-Carvajal JC, Moreno-Aranda J, Martinez-Sanchez R
Language: Spanish
References: 45
Page: 435-448
PDF size: 573.31 Kb.
ABSTRACT
This device consists of a woven in a form of a tubular mesh, made up for
the use in the urethra. We report the clinical and uroflujometric results
in 10 patients with urethral stricture and 4 with obstructive prostatic
hyperplasia. The study includes a 7 year period since October of 1993 up
until June 2000. All patients were evaluated pre and post stent insertion
with periodic follow ups to assess the prostatic symptoms score, quality
of life assessment, peak urinary flow rate, mean flow rate and post-void
residual urine volume. The results were the following: For the group
with urethral stricture the I-PSS decreased from 26.8 to 5.4 points, the
peak flow rate increased from 8.24 to 16.12 mL/sec and the post-void
residual urine volume decreased from 42.7 to 31.6 mL. By 12-month
follow-up most endoprostheses were 90% covered with urothelium, only one
of these patients required stent extraction with no sphincter lesion.
For the prosthatic hyperplasia group the I-PSS decreased from 20.2 to 8
points. The peak flow rate increased from 6.95 to 14.5 mL/sec and the
post-void residual urine volume decreased from 49 to 18.3 mL. By 12-month
follow-up two patients were 95% covered with epithelium, and the other
two were 70%. There have not been significant problems related to
infections, migration, incontinence or erectil disfunction. An 80% of
patients have shown some irritative symptoms (urgency, frequency or
dysuria) at least during the first month after stent insertion. These 7
year results suggest that Urolume urethral endoprostheses can be a
long-term effective treatment alternative to these patients.
REFERENCES
Jordan GH, Schlossberg SM, Devine CJ. Surgery of the penis and urethra. In: Walsh P, Retik A, Vaughan E, Wein A, editors. Campbell’s Urology. Seventh Edition. WB Saunders Company; p 3341
Chapple CR, Rickards D, Milroy E. Permanently implanted urethral stents. Seminars in Interventional Radiology 1991;8:284-294.
Dhom G. Próstata. In: Doerr W, Seifert G, Springer editors. Spezielle pathologische Anatomie. chapt 21. p. 445, 1992
Peters CA, Walsh PC. The effect of nafarelin acetate, a luteinizing hormone-releasing hormone agonist, on benign prostatic hyperplasia. N Engl J Med 1987;317:599-604.
Caine M, Perlberg S, Gordon R. The treatment of benign prostatic hipertrophy with flutamide (SCH 13521): a placebo-controlled study. J Urol 1975; 144: 564
Donnell R, Leport H. Alpha-blockaed for benign prostatic hyperplasia. J Endourol 199;5:83.
Brooks JR, Berman C, Garnes D, Giltinan D, Gordon LR, Malatesta PF, et al. Prostatic effects induced in dogs by chronic or acute oral administration of 5-alfa-reductasa inhibitors. Prostate 1986;9:65.
Gormley GJ, Stoner E, Bruskewitz RC, Imperato-McGinley J, Walsh PC, McConnell JD, et al. The effect of finasteride in men with benign postatic hyperplasia. The Finasteride Study Group. N Engl J Med 1992;327:1185-1191.
Schweikert HU, Tunn UW. Effects of the aromatase inhibitor testolactona on human benign prostatic hyperplasia. Steroids 1987;50:191-200.
Sirls LT, Ganabath K, Zimmern PE, Roskamp DA, Wolde-Tsadik G, Leach GE. Transurethral incision of the prostate: an objective and subjective evaluation of long-term efficacy. J Urol 1993;150:1615-1621.
Montorsi F, Galli L, Guazzoni G, Colombo R, Bulfamante G, Barbieri L, et al. Transurethral microwave hiperthermia for benign prostatic hyperplasia: Long term clinical, pathological and ultrastructural patterns. J Urol 1992;148:321.
Baert L, Ameye F, Willemen P, Vandenhove J, Lauweryns J, Astrahan M, et al. Transurethral microwave hyperthermia for benign prostatic hyperplasia: preliminary clinical and pathological results. J Urol 1990;144:1383-1387.
Reddy PK, Wasserman N, Castañeda F, Castañeda-Zuñiga WR. Balloon dilatation of the prostate for treatment of benign prostatic hyperplasia. Urol Clin North Am 1988;15:529.
Reddy PK. Balloon dilation of the prostate: principles and techniques. J Endourol 1991;5:93.1991.
Blute ML, Tomera KM, Hellerstein DK, McKiel CF Jr, Lynch JH, Regan JB, et al. Tranurethral microwave thermotherapy for management of benign prostatic hyperplasia: Results of the United States Prostatron Cooperative Study. J Urol 1993;150:1591-1596.
Costello Aj, Bowsher WG, Bolton DM, Braslis KG, Burt J. Laser ablation of the prostate in patients with benign prostatic hypertrophy. Br J Urol 1992;69:603-608.
McCullough DL, Roth RA, Babayan RK, Gordon JO, Reese JH, Crawford ED, et al. Transurethral ultrasound-guide laser-induced prostatectomy: National Human Cooperative Study results. J Urol 1993;150:1607-1611.
Mebust WK. Surgical management of benign prostatic obstruction. Urology 1988; 32 Suppl. 12-15
Doll HA. Black NA, McPherson K, Flood AB, Williams GB, Smith JC. Mortality, morbidity and complications following transurethral resection of the prostate for benign prostatic hypertrophy. J Urol 1992;147:1566.
Mebust WK., Holtgrewe HL, Cockett ATK, Peters PC. and Writing Committee. Transurethral prostatectomy: inmediate and postoperative complications. A cooperative study of 13 participating institutions evaluating 3.885 patients. J Urol 1989;141:243.
Oesterling JE. Urologic applications of a permanent, epithelializing urethral endoprosthesis. Urology 1993;41 Suppl 1:10-18.
Parikh AM, Milroy JG. A new technique for removal of the Urolume prostate stent. Br J Urol 1993;71:620.
Oesterling JE. Technique of transuretrhal incision of the prostate (TUIP) and placement of the prostatic UroLume endoprosthesis. Atlas, Urol Clin North Am 1994 (in press, November 1994)
Sigwart U, Puel J, Mirkovitch U, Joffre F. Kappenberger, L. Intravascular stents to prevent occlusion and reestenosis after transluminal angioplasty. N Engl J Med 1987;316:(12)701.
Becker GJ. Intravascular stents: General principles and status of lower extremity arterial aplications. Circulation 1991;83 Suppl. 1:1-122, 1-136.
Dick R, Gillams A, Dooley JS, Hobbs EF. Stainless steel mesh stents for biliary strictures. J Intervent Radiol 1989;4:95-98.
Oesterling JE. Urologic applications of a permanent epitheliazing urethral endoprothesis. Urology 1993;41 Suppl 1:10-18.
Williams G, Coulange C, Milroy EJ, Sarramon JP, Rubben H. The Urolume a permanently implanted prostatic stent for patients at high risk for surgery. Result from 5 collaborative centers. Br J Urol 1993;72:335-340.
Guazzoni G, Bergamaschi F, Montorsi F, Consonni P, Galli L, Matozzo V. Prostatic Urolume wallstent for benign prostatic hyperplasia patients at poor operative risk: Clinical, uroflowmetric and ultrasonographic patterns. J Urol 1993;150:1641-1647.
Guazzoni G, et al. A modified prostatic Urolume wallstent for healthy patients with syntomatic benign prostatic hiperplasia: A european multicenter study. Urology 1994;44:(3)364-370.
Anjum MI, Chari R, Shetty A, Keen M, Palmer JH. Long-term clinical results of quality of life after insertion of a self expanding flexible endourethral prosthesis. Br J Urol 1997;80:885-888.
Chapple CR, Milroy EJ, Rickards D. Permanently implanted urethral stent for prostatic obstruction in the unfit patient. Preliminary report. Br J Urol 1990;66:58.
Shaw PJR, Milroy EJG. Permanent external striated sphincter stents in patients with spinal injuries. Br J Urol 1990;66:297-302.
McInerney PD, Vanner TF, Harris SAB, Stephenson TP. Permanent urethtral stents for detrusor sphincter dyssynergia. Br J Urol 1991;67:291-294.
Fabian KM. Der intraprostatitische “Partielle Katheter” (Urologische Spirale). Urologe A 1980;19:236.
Morgenthaler A, DeWolf WC. A self-expanding prostatic stent for bladder outlet obstruction in high risk patients. J Urol 1993;150:1636.
Nordling J, Ovesen H, Poulsen AL. The intraprostatic spiral: clinical results in 150 consecutive patients. J Urol 1992;147:645.
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.
Milroy EJG, Chapple CR, Cooper JE, Eldin A, Wallstent H. A new treatment for urethral strictures. Lancet 1988;1424-1427.
Williams G, Jaeger R, McLoughlin J. Prostatic stents: A new treatment for prostatic outflow obstruction in patients unfit for surgery. Br Med J 1989;298:1429.
Williams G, Coulange C, Milroy EJ, Sarramon JP, Rubben H. The Urolume a permanently implanted prostatic stent for patients at high risk for surgery. Result from 5 collaborative centers. Br J Urol 1993;72:335-340.
Oesterling J, Defalco A, Kaplan S, Reddy P, Epstein H, Chancellor M. and de North American Urolume study group. The North American experience with the Urolume endoprosthesis as a treatment for benign prostatic hiperplasia: Long term results. Urology 1994;44:(3)353-362.
Baldani GH, Press SM, Defalco A, Oesterling JE, Smith AD. and the north american urolume study group. Urolume endourethral prosthesis for the treatment of urethral stricture disease: Long-term results of the north american multicenter urolume trial. Urology 1995;45:846-856.
Ashken MH, Coulange C, Milroy EJ and Sarramon JP. European experience with the urethral wallstent for urethral strictures. Eur Urol 1991;19:181–185.
Bassi S, Puscinski A, Lata J, Netto NR, Lima M, Dávila H, Vargas J, López MA, Berkowski E, Moreno AJ, Garcia IC, Serrano BE, Vargas RD, Valdevenito R, Lucon AM, Mitre A, Freire GC, Arap S, Vaz F. The urolume endoprothesis as minimal invasive in the treatment of prostatic obstruction: the Latin American experience. American Urological Association Meeting 1997.