Skip to main content
Top
Published in: CardioVascular and Interventional Radiology 4/2007

01-07-2007 | Laboratory Investigation

Evaluation of the Effects of Temporary Covered Nitinol Stent Placement in the Prostatic Urethra: Short-Term Study in the Canine Model

Authors: Verónica Crisóstomo, Ho Young Song, Manuel Maynar, Fei Sun, Federico Soria, Juan Rafael Lima, Chang Jin Yoon, Jesús Usón-Gargallo

Published in: CardioVascular and Interventional Radiology | Issue 4/2007

Login to get access

Abstract

Purpose

To evaluate the effect of temporary stent placement on the canine prostatic urethra.

Methods

Retrievable PTFE-covered nitinol stents were placed in the prostatic urethras of 8 beagle dogs under fluoroscopic guidance. Retrograde urethrography was obtained before and after stenting. Retrograde urethrography and endoscopy were performed 1 and 2 months after deployment. The endoscopic degree of hyperplasia was rated on a scale of 0 to 4 (0 = absence, 4 = occlusion). On day 60, stents were removed and urethrography was performed immediately before euthanasia. Pathologic analysis was performed to determine the degree of glandular atrophy, periurethral fibrosis, and urethral dilation.

Results

Stent deployment was technically successful in 7 animals, and failed in 1 dog due to a narrow urethral lumen. Complete migration was seen in 2 animals at 1 month, and an additional stent was deployed. On day 30, endoscopy showed slight hyperplasia (grade 1) in 3 animals. On day 60, moderate hyperplasia (grade 2) was evidenced in 4 cases. No impairment of urinary flow was seen during follow-up. Retrieval was technically easy to perform, and was successful in all dogs. The major histologic findings were chronic inflammatory cell infiltrates; prostate glandular atrophy, with a mean value of 1.86 (SD 0.90); periurethral fibrosis, with a mean ratio of 29.37 (SD 10.41); and dilatation of the prostatic urethra, with a mean ratio of 6.75 (SD 3.22).

Conclusion

Temporary prostatic stent placement in dogs is safe and feasible, causing marked enlargement of the prostatic urethral lumen. Retrievable covered stents may therefore be an option for bladder outlet obstruction management in men.
Literature
1.
go back to reference Berry SJ, Coffey DS, Walsh PC, et al. (1984) The development of human benign prostatic hyperplasia with age. J Urol 132:474–479PubMed Berry SJ, Coffey DS, Walsh PC, et al. (1984) The development of human benign prostatic hyperplasia with age. J Urol 132:474–479PubMed
2.
go back to reference AUA Practice Guidelines Committee (2003) AUA Guideline on management of benign prostatic hyperplasia. Chapter 1: Diagnosis and treatment recommendations. J Urol 170:530–547CrossRef AUA Practice Guidelines Committee (2003) AUA Guideline on management of benign prostatic hyperplasia. Chapter 1: Diagnosis and treatment recommendations. J Urol 170:530–547CrossRef
3.
go back to reference Ogiste JS, Cooper K, Kaplan SA (2003) Are stents still a useful therapy for benign prostatic hyperplasia? Curr Opin Urol 13:51–57PubMedCrossRef Ogiste JS, Cooper K, Kaplan SA (2003) Are stents still a useful therapy for benign prostatic hyperplasia? Curr Opin Urol 13:51–57PubMedCrossRef
4.
go back to reference Masood S, Djaladat H, Kouriefs C, et al. (2004) The 12-year outcome analysis of an endourethral Wallstent for treating benign prostatic hyperplasia. Br J Urol Int 94:1271–1274 Masood S, Djaladat H, Kouriefs C, et al. (2004) The 12-year outcome analysis of an endourethral Wallstent for treating benign prostatic hyperplasia. Br J Urol Int 94:1271–1274
5.
go back to reference Fabian KM (1980) The intraprostatic “partial catheter” (urological spiral). Urologe A 19:236–238PubMed Fabian KM (1980) The intraprostatic “partial catheter” (urological spiral). Urologe A 19:236–238PubMed
6.
go back to reference Fitzpatrick JM, Mebust WK (2002) Minimally invasive and endoscopic management of benign prostatic hyperplasia. In: Walsh PC, Retik AB, Vaughan DE, Wein AJ (eds) Campbell’s urology, 8th edn. WB Saunders, New York, pp 1380–1417 Fitzpatrick JM, Mebust WK (2002) Minimally invasive and endoscopic management of benign prostatic hyperplasia. In: Walsh PC, Retik AB, Vaughan DE, Wein AJ (eds) Campbell’s urology, 8th edn. WB Saunders, New York, pp 1380–1417
7.
go back to reference Oesterling JE, Defalco AJ, Kaplan SA, et al. (1994) The North American experience with the UroLume endoprothesis as a treatment for benign prostatic hyperplasia: Long-term results. Urology 44:353–362PubMedCrossRef Oesterling JE, Defalco AJ, Kaplan SA, et al. (1994) The North American experience with the UroLume endoprothesis as a treatment for benign prostatic hyperplasia: Long-term results. Urology 44:353–362PubMedCrossRef
8.
go back to reference Badlani GH, Press SM, Defalco A, et al. (1995) Urolume endourethral prosthesis for the treatment of urethral stricture disease: Long term results for the North American multicenter Urolume trial. Urology 45:846–856PubMedCrossRef Badlani GH, Press SM, Defalco A, et al. (1995) Urolume endourethral prosthesis for the treatment of urethral stricture disease: Long term results for the North American multicenter Urolume trial. Urology 45:846–856PubMedCrossRef
9.
go back to reference Williams G, Coulane C, Milroy EJ, et al. (1993) The Urolume, a permanently implanted prostatic stent for patients at high risk for surgery: Result from 5 collaborative centres. Br J Urol 72:335–340PubMed Williams G, Coulane C, Milroy EJ, et al. (1993) The Urolume, a permanently implanted prostatic stent for patients at high risk for surgery: Result from 5 collaborative centres. Br J Urol 72:335–340PubMed
10.
go back to reference Guazzoni G, Montorsi F, Coulange C, et al. (1994) A modified prostatic Urolume Wallstent for healthy patients with symptomatic benign prostatic hyperplasia: A European multicenter study. Urology 44:364–370PubMedCrossRef Guazzoni G, Montorsi F, Coulange C, et al. (1994) A modified prostatic Urolume Wallstent for healthy patients with symptomatic benign prostatic hyperplasia: A European multicenter study. Urology 44:364–370PubMedCrossRef
11.
go back to reference Gesengerg A, Sintermann R (1998) Management of benign prostatic hyperplasia in high risk patients: Long term experience with the Memotherm stent. J Urol 160:72–76CrossRef Gesengerg A, Sintermann R (1998) Management of benign prostatic hyperplasia in high risk patients: Long term experience with the Memotherm stent. J Urol 160:72–76CrossRef
12.
go back to reference Shah DK, Kapoor R, Badlani GH, et al. (2003) Experience with urethral stent explantation. J Urol 169:1398–1400PubMedCrossRef Shah DK, Kapoor R, Badlani GH, et al. (2003) Experience with urethral stent explantation. J Urol 169:1398–1400PubMedCrossRef
13.
14.
go back to reference De la Rossette JJ (2000) What we do and don’t know about benign prostatic hyperplasia. Curr Opin Urol 10:1–2CrossRef De la Rossette JJ (2000) What we do and don’t know about benign prostatic hyperplasia. Curr Opin Urol 10:1–2CrossRef
15.
go back to reference Ko GY, Kim GC, Seo TS, et al. (2002) Covered, retrievable, expandable urethral nitinol stent: Feasibility study in dogs. Radiology 223:83–90PubMedCrossRef Ko GY, Kim GC, Seo TS, et al. (2002) Covered, retrievable, expandable urethral nitinol stent: Feasibility study in dogs. Radiology 223:83–90PubMedCrossRef
16.
go back to reference Song HY, Park H, Suh TS, et al. (2003) Recurrent traumatic urethral strictures near the external sphincter: Treatment with a covered, retrievable, expandable nitinol stent. Initial results. Radiology 226:433–440 Song HY, Park H, Suh TS, et al. (2003) Recurrent traumatic urethral strictures near the external sphincter: Treatment with a covered, retrievable, expandable nitinol stent. Initial results. Radiology 226:433–440
17.
go back to reference Shin JH, Song HY, Park H, et al. (2006) Removal of retrievable self-expandable urethral stents: Experience in 58 stents. Eur Radiol 16:2037–2043PubMedCrossRef Shin JH, Song HY, Park H, et al. (2006) Removal of retrievable self-expandable urethral stents: Experience in 58 stents. Eur Radiol 16:2037–2043PubMedCrossRef
18.
go back to reference Guidelines for the care, use of laboratory animals (1996) Institute of Laboratory Animal Resources. Commission on Life Sciences. National Research Council. National Academy Press, Washington, DC Guidelines for the care, use of laboratory animals (1996) Institute of Laboratory Animal Resources. Commission on Life Sciences. National Research Council. National Academy Press, Washington, DC
19.
go back to reference AVMA Panel on Euthanasia (2001) Report of the AVMA Panel on Euthanasia. J Am Vet Med Assoc 218:669–696CrossRef AVMA Panel on Euthanasia (2001) Report of the AVMA Panel on Euthanasia. J Am Vet Med Assoc 218:669–696CrossRef
20.
go back to reference Gajewski JB, Chancellor MB, Ackman CF, et al. (2000) Removal of UroLume endoprosthesis: Experience of the North American Study Group for detrusor-sphincter dyssynergia application. J Urol 163:773–776PubMedCrossRef Gajewski JB, Chancellor MB, Ackman CF, et al. (2000) Removal of UroLume endoprosthesis: Experience of the North American Study Group for detrusor-sphincter dyssynergia application. J Urol 163:773–776PubMedCrossRef
21.
go back to reference Anjum MI, Chari R, Shetty A, et al. (1997) Long-term clinical results and quality of life after insertion of a self-expanding flexible endourethral prosthesis. Br J Urol 80:885–888PubMed Anjum MI, Chari R, Shetty A, et al. (1997) Long-term clinical results and quality of life after insertion of a self-expanding flexible endourethral prosthesis. Br J Urol 80:885–888PubMed
22.
go back to reference Barber NK, Roodhouse AJ, Rathenborg P, et al. (2005) Ease of removal of thermo-expandable prostate stents. Br J Urol Int 96:578–580 Barber NK, Roodhouse AJ, Rathenborg P, et al. (2005) Ease of removal of thermo-expandable prostate stents. Br J Urol Int 96:578–580
23.
go back to reference Perry MJA, Roodhouse AJ, Gidlow AB, et al. (2002) Thermo-expandable intraprostatic stents in bladder outlet obstruction: An 8-year study. Br J Urol Int 90:216–223 Perry MJA, Roodhouse AJ, Gidlow AB, et al. (2002) Thermo-expandable intraprostatic stents in bladder outlet obstruction: An 8-year study. Br J Urol Int 90:216–223
24.
go back to reference Kapoor R, Liatsikos EN, Badlani G (2000) Endoprostatic stents for management of benign prostatic hyperplasia. Curr Opin Urol 10:19–22PubMedCrossRef Kapoor R, Liatsikos EN, Badlani G (2000) Endoprostatic stents for management of benign prostatic hyperplasia. Curr Opin Urol 10:19–22PubMedCrossRef
25.
go back to reference Dobben RL, Wright KC, Dolenz D, et al. (1991) Prostatic urethra dilatation with the Gianturco self-expanding metallic stent: A feasibility study in cadaver specimens and dogs. AJR Am J Roentgenol 156:757–761PubMed Dobben RL, Wright KC, Dolenz D, et al. (1991) Prostatic urethra dilatation with the Gianturco self-expanding metallic stent: A feasibility study in cadaver specimens and dogs. AJR Am J Roentgenol 156:757–761PubMed
26.
go back to reference Bailey DM, Foley SJ, McFarlane JP, et al. (1998) Histological changes associated with long-term urethral stents. Br J Urol 81:745–749PubMed Bailey DM, Foley SJ, McFarlane JP, et al. (1998) Histological changes associated with long-term urethral stents. Br J Urol 81:745–749PubMed
27.
go back to reference Pomer S, Dobrowolski ZF (2002) The therapy of benign prostatic hyperplasia using less-invasive procedures: The current situation. Br J Urol Int 89:773–775 Pomer S, Dobrowolski ZF (2002) The therapy of benign prostatic hyperplasia using less-invasive procedures: The current situation. Br J Urol Int 89:773–775
28.
go back to reference Djavan B, Fakhari M, Shariat S, et al. (1999) A novel intraurethral prostatic bridge catheter for prevention of temporary prostatic obstruction following high energy transurethral microwave thermotherapy in patients with benign prostatic hyperplasia. J Urol 161:144–151PubMedCrossRef Djavan B, Fakhari M, Shariat S, et al. (1999) A novel intraurethral prostatic bridge catheter for prevention of temporary prostatic obstruction following high energy transurethral microwave thermotherapy in patients with benign prostatic hyperplasia. J Urol 161:144–151PubMedCrossRef
Metadata
Title
Evaluation of the Effects of Temporary Covered Nitinol Stent Placement in the Prostatic Urethra: Short-Term Study in the Canine Model
Authors
Verónica Crisóstomo
Ho Young Song
Manuel Maynar
Fei Sun
Federico Soria
Juan Rafael Lima
Chang Jin Yoon
Jesús Usón-Gargallo
Publication date
01-07-2007
Publisher
Springer-Verlag
Published in
CardioVascular and Interventional Radiology / Issue 4/2007
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-007-9006-9

Other articles of this Issue 4/2007

CardioVascular and Interventional Radiology 4/2007 Go to the issue