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Abstract
Benign prostatic hyperplasia (BPH) is a common cause of lower urinary tract symptoms (LUTS) in men. In our practice, we employ Transurethral Microwave Thermotherapy (TUMT) as an effective and minimally invasive means of treating BPH for patients presenting with small to moderate prostate size. TUMT utilizes the transfer of heat to necrotize prostatic tissue in the treatment zone, resulting in prostatic edema that can temporarily exacerbate symptoms during the post-procedure recovery period. Management of post-procedure voiding symptoms often requires the use of an indwelling urinary catheter (IUC), in some cases, for an extended period. We systematically replace post-TUMT IUC with temporary prostatic stents (TPS) to alleviate voiding symptoms, reduce infection risk and improve the quality of life during recovery. The purpose of this study is to assess the clinical efficacy of TPS using The Spanner® Temporary Prostatic Stent in men with BPH, post initial catheterization following TUMT. This review documents the effects of TPS on post-void-residual (PVR), infection rate, and complication rate in 25 consecutive men treated with our TUMT/TPS protocol. Our data demonstrates that TPS had effectively reduced edema-related urethral resistance in the post-TUMT recovery period, resulting in reduced PVR and no incidence of infection.
Public Interest Statement
Non-malignant enlargement of the prostate, known as benign prostatic hyperplasia or BPH, is a common disease among aging males. The increase in prostate size often results in urinary symptoms as the urethra becomes obstructed. Transurethral Microwave Thermotherapy (TUMT) is one of several in-office therapies used to treat BPH. Energy applied by TUMT causes the prostate to temporarily swell in the post-procedure period, causing urinary symptoms to exacerbate as the prostate heals. This may prolong symptoms and lengthen the need for urinary catheterization.
To limit the use of urinary catheters, our practice routinely replaces indwelling urinary catheters with temporary prostate stents (TPS) at 48 h. This review is the first of its kind to demonstrate real-world evidence that TPS offer a safe and efficacious means of alleviating urinary symptoms; providing the ability to void naturally without the complications common with urinary catheterization.
Competing Interests
The authors declare no competing interest.
Additional information
Notes on contributors
Dimitri Kessaris
Dimitri Kessaris is the Medical Director at Progressive Urology in New York. He is board certified by the American Board of Urology. Kessaris received his Bachelors of Arts in Chemistry at New York University and Medical degree from Stony Brook University Medical School. He did his general surgery and urology residency training at Long Island Jewish Medical Center.
He is also a member of professional organizations including the American Urological Association, the Hellenic Medical Society, and the Medical Society of the County of Queens.