BACKGROUND & AIMS:
:Recently, more and more alternative therapeutic methods have been used for the treatment of benign prostatic hyperplasia (BPH). We will report on therapeutic results with a new thermosensitive stent system (Memotherm). This wire mesh stent has been designed especially for urological purposes. It is made of Nitinol, a thermoreactive material, and gains its maximum expansion force al body temperature. Due to the properties of the material the stent is flexible and can adapt to the anatomical conditions of the prostatic part of the urethra. Because of individual variations in the length of the prostatic part of the urethra, the system is available in lengths from 2 to 8 cm. The knitted structure for the first time allows atraumatic removal. Between April, 1992, and September, 1993, we treated a total of 54 BPH patients with the stent system. Mean patient age was 76.1 +/- 7.6 years (61-98). Mean prostatic volume was 51.9 +/- 25 ml (20-150), and the length of the applicated stents was 32.3 +/- 9.5 mm (20-70). Patient selection for stent treatment was carried out with regard to the preoperative risk status of this patient group. Fourteen (26%) of the patients treated were able to micturate before operation; in 40 (74%) urinary drainage was accomplished by means of an indwelling catheter. Following stent application, 53 out of 54 patients were able to micturate. With the first group (preoperative voiding ability), maximum flow had increased from 4.5 ml/s to a mean of 15.8 ml/s, while residual urine volume had decreased from 194.4 ml to 11.8 ml and the AUA 6 Symptoms Score had improved from 24 points to 3.5 points 6 months after stent application. All differences were statistically significant (P < 0.02). With the second group (no preoperative voiding ability), the AUA 6 Symptoms Score had improved from 25 points to 3.9 points (P < 0.02) 6 months after the operation, at which time the mean maximum flow rate was 14.8 ml/s and residual urine volume 14.8 ml. There was no statistically significant difference between the patients who were able and those who were unable to micturate before operation. One case of epididymitis was the only major complication observed after stent placement. Frequent urgency symptoms (30 out of 54 patients; 55.5%) subsided after a mean period of 1 week. The Memotherm stent offers an interesting therapeutic alternative for BPH risk patients.
背景与目标:
: 最近,越来越多的替代治疗方法已用于治疗良性前列腺增生 (BPH)。我们将报告新的热敏支架系统 (Memotherm) 的治疗结果。这种金属丝网支架是专门为泌尿外科目的设计的。它由镍钛诺 (一种热活性材料) 制成,并获得最大的膨胀力和体温。由于材料的特性,支架是柔性的,可以适应尿道前列腺部分的解剖条件。由于尿道的前列腺部分的长度的个体变化,该系统的长度为2至8厘米。针织结构首次允许无损伤去除。在1992年4月和1993年9月之间,我们总共用支架系统治疗了54例BPH患者。患者平均年龄为76.1 +/- 7.6岁 (61-98岁)。平均前列腺体积为51.9 +/-25毫升 (20-150),应用支架的长度为32.3 +/-9.5毫米 (20-70)。根据该患者组的术前风险状况进行了支架治疗的患者选择。接受治疗的患者中有14名 (26% 名) 能够在手术前进行排尿; 在40名 (74% 名) 中,通过留置导管完成了尿液引流。支架应用后,54例患者中有53例能够排尿。对于第一组 (术前排尿能力),最大流量从4.5毫升/s增加到平均15.8毫升/s,而残余尿量从194.4毫升减少到11.8毫升,AUA 6症状评分从24分提高到3.5分。支架应用6个月后。所有差异均有统计学意义 (P <0.02)。第二组 (无术前排尿能力),术后6个月AUA 6症状评分从25分提高到3.9分 (P <0.02),平均最大流量为14.8毫升/s,残余尿量14.8毫升。能够与术前无法排尿的患者之间没有统计学上的显着差异。1例附睾炎是支架置入后唯一观察到的主要并发症。平均1周后,频繁的紧急症状 (54例患者中有30例; 55.5% 例) 消退。Memotherm支架为BPH风险患者提供了一种有趣的治疗选择。