Use of a Temporary Prostatic Stent After Transurethral Microwave Thermotherapy Reduced Voiding Symptoms and Bother Without Exacerbating Irritative Symptoms

• Published in: Urology (Ridgewood, N.J.) N.J.), 2008-05, Vol.71 (5), p.873-877
• Main Authors: Dineen, Martin K, Shore, Neal D, Lumerman, Jeffrey H, Saslawsky, Mark J, Corica, Alberto P
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Humans; Male; Medical sciences; Nephrology. Urinary tract diseases; Stents; Time Factors; Transurethral Resection of Prostate - adverse effects; Urination Disorders - etiology; Urination Disorders - prevention & control; Urology
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2007.12.015

Objectives To evaluate the ability of a temporary prostatic stent (Spanner [Sp]) to manage voiding symptoms, irritative symptoms, and bother after transurethral microwave thermotherapy (TUMT) for prostatic obstruction. Methods Patients were randomized to the Sp (n = 100) or standard of care (SOC, n = 86) after TUMT with 3 to 10 days of routine catheterization. We evaluated International Prostate Symptom Score (IPSS) voiding subscore, IPSS irritative subscore, voiding diary data, and Benign Prostatic Hyperplasia Impact Index (BII) 7 to 10 days before TUMT and repeated them 1, 2, 4 (stent removal), 5, and 8 weeks after stent insertion. Results After 1 week of stent use, the Sp group experienced significantly greater improvements in the IPSS voiding subscore (Sp = −4.9 versus SOC = −2.3, P = 0.002) and individual voiding symptoms assessed by the IPSS (intermittency, weak stream, and straining) and voiding diary data (stream strength, and strain). After 2 weeks, the Sp group showed a trend toward greater improvements in IPSS voiding ( P = 0.059) and irritative ( P = 0.058) subscores and reported significantly less bother (BII, Sp = −2.1 versus SOC = −1.1, P = 0.033). After stent removal, the Sp group reported significantly greater improvements in the IPSS irritative subscore (5 weeks: Sp = −4.0 versus SOC = −2.7, P = 0.029; 8 weeks: Sp = −5.0 versus SOC = −4.0, P = 0.050), individual voiding (stream strength and dysuria), and irritative (frequency and urgency) symptoms and bother (5 weeks: Sp = −4.0 versus SOC = −2.3, P = 0.002; 8 weeks: Sp = −5.0 versus SOC = −3.1, P = 0.001). Conclusions The Spanner, a temporary prostatic stent, improved voiding symptoms and bother without exacerbating irritative symptoms. Improvements in symptoms and bother were sustained after stent removal.