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Published in: European Radiology 3/2013

01-03-2013 | Interventional

Placement of retrievable self-expandable metallic stents with barbs into patients with obstructive prostate cancer

Authors: Ho-Young Song, Choung Soo Kim, In Gab Jeong, Dalsan Yoo, Jin Hyoung Kim, Deok Ho Nam, Jae-Ik Bae, Jung-Hoon Park

Published in: European Radiology | Issue 3/2013

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Abstract

Objectives

To evaluate the technical feasibility and clinical effectiveness of retrievable self-expandable metallic stents with barbs in patients with obstructive prostate cancer.

Methods

Retrievable self-expandable metallic stents with eight barbs each were inserted into eight consecutive patients with obstructive prostate cancer. Patient ages ranged from 55 to 76 years (mean, 69 years). All eight patients had previously received hormone therapy, and three had undergone palliative transurethral prostatectomy. Stents were removed using a 21-F stent removal set if they caused complications.

Results

Stent placement was technically successful and well tolerated in all patients. One had severe incontinence, which improved spontaneously, and two had gross haematuria, which disappeared spontaneously within 4 days. Peak urine flow rates and post-void residual urine volumes 1 month after stent placement were 5.6–10.2 ml/s (mean, 8.3 ml/s), and 5–45 ml (mean, 27 ml), respectively. During a mean follow-up of 192 days (range, 39–632 days), one patient required stent removal after 232 days because of stone formation within the stent. No further intervention was required because the mass improved after stent removal.

Conclusions

These preliminary results suggest that retrievable stents with eight barbs are both feasible to place and effective in patients with obstructive prostate cancer.

Key Points

Retrievable metallic urethral stents can help patients with obstructive prostate cancer.
Retrievable self-expandable stents with eight barbs are both feasible and effective.
These stents apparently overcome the problem of stent migration.
Removal of these stents was safe without surgery under local anaesthesia.
Literature
1.
go back to reference Crain DS, Amling CL, Kane CJ (2004) Palliative transurethral prostate resection for bladder outlet obstruction in patients with locally advanced prostate cancer. J Urol 171:668–671PubMedCrossRef Crain DS, Amling CL, Kane CJ (2004) Palliative transurethral prostate resection for bladder outlet obstruction in patients with locally advanced prostate cancer. J Urol 171:668–671PubMedCrossRef
2.
3.
go back to reference McGowan DG (1980) The adverse influence of prior transurethral resection on prognosis in carcinoma of the prostate treated by radiation therapy. Int J Radiat Oncol Biol Phys 6:1121–1126PubMedCrossRef McGowan DG (1980) The adverse influence of prior transurethral resection on prognosis in carcinoma of the prostate treated by radiation therapy. Int J Radiat Oncol Biol Phys 6:1121–1126PubMedCrossRef
4.
go back to reference Hanks GE, Leibel S, Kramer S (1983) The dissemination of cancer by transurethral resection of locally advanced prostate cancer. J Urol 129:309–311PubMed Hanks GE, Leibel S, Kramer S (1983) The dissemination of cancer by transurethral resection of locally advanced prostate cancer. J Urol 129:309–311PubMed
5.
go back to reference Forman JD, Order SE, Zinreich ES et al (1986) The correlation of pretreatment transurethral resection of prostatic cancer with tumour dissemination and disease-free survival. A univariate and multivariate analysis. Cancer 58:1770–1778PubMedCrossRef Forman JD, Order SE, Zinreich ES et al (1986) The correlation of pretreatment transurethral resection of prostatic cancer with tumour dissemination and disease-free survival. A univariate and multivariate analysis. Cancer 58:1770–1778PubMedCrossRef
6.
go back to reference Krupski TL, Stukenborg GJ, Moon K, Theodorescu D (2010) The relationship of palliative transurethral resection of the prostate with disease progression in patients with prostate cancer. BJU Int 106:1477–1483PubMedCrossRef Krupski TL, Stukenborg GJ, Moon K, Theodorescu D (2010) The relationship of palliative transurethral resection of the prostate with disease progression in patients with prostate cancer. BJU Int 106:1477–1483PubMedCrossRef
7.
go back to reference Song HY, Do YS, Han YM et al (1994) Covered, expandable esophageal metallic stent tubes: experiences in 119 patients. Radiology 193:689–695PubMed Song HY, Do YS, Han YM et al (1994) Covered, expandable esophageal metallic stent tubes: experiences in 119 patients. Radiology 193:689–695PubMed
8.
go back to reference Kim JH, Song HY, Shin JH et al (2007) Metallic stent placement in the palliative treatment of malignant gastroduodenal obstructions: prospective evaluation of results and factors influencing outcome in 213 patients. Gastrointest Endosc 66:256–264PubMedCrossRef Kim JH, Song HY, Shin JH et al (2007) Metallic stent placement in the palliative treatment of malignant gastroduodenal obstructions: prospective evaluation of results and factors influencing outcome in 213 patients. Gastrointest Endosc 66:256–264PubMedCrossRef
9.
go back to reference Ornellas LC, Stefanidis G, Chuttani R, Gelrud A, Kelleher TB, Pleskow DK (2009) Covered Wallstents for palliation of malignant biliary obstruction: primary stent placement versus reintervention. Gastrointest Endosc 70:676–683PubMedCrossRef Ornellas LC, Stefanidis G, Chuttani R, Gelrud A, Kelleher TB, Pleskow DK (2009) Covered Wallstents for palliation of malignant biliary obstruction: primary stent placement versus reintervention. Gastrointest Endosc 70:676–683PubMedCrossRef
10.
go back to reference Kim CS, Song HY, Jeong IG et al (2011) Temporary placement of covered retrievable expandable nitinol stents with barbs in high-risk surgical patients with benign prostatic hyperplasia: work in progress. J Vasc Interv Radiol 22:1420–1426PubMedCrossRef Kim CS, Song HY, Jeong IG et al (2011) Temporary placement of covered retrievable expandable nitinol stents with barbs in high-risk surgical patients with benign prostatic hyperplasia: work in progress. J Vasc Interv Radiol 22:1420–1426PubMedCrossRef
11.
go back to reference Barry MJ, Fowler FJ Jr, O’Leary MP et al (1992) The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol 148:1549–1557PubMed Barry MJ, Fowler FJ Jr, O’Leary MP et al (1992) The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol 148:1549–1557PubMed
12.
go back to reference Antonarakis ES, Eisenberger MA (2011) Expanding treatment options for metastatic prostate cancer. N Engl J Med 364:2055–2058PubMedCrossRef Antonarakis ES, Eisenberger MA (2011) Expanding treatment options for metastatic prostate cancer. N Engl J Med 364:2055–2058PubMedCrossRef
13.
go back to reference Oefelein MG (2004) Prognostic significance of obstructive uropathy in advanced prostate cancer. Urology 63:1117–1121PubMedCrossRef Oefelein MG (2004) Prognostic significance of obstructive uropathy in advanced prostate cancer. Urology 63:1117–1121PubMedCrossRef
14.
go back to reference Chapple CR, Milroy EJG, Rickards D (1990) Permanently implanted urethral stent for prostatic obstruction in the unfit patient. Preliminary report. Br J Urol 66:58–65PubMedCrossRef Chapple CR, Milroy EJG, Rickards D (1990) Permanently implanted urethral stent for prostatic obstruction in the unfit patient. Preliminary report. Br J Urol 66:58–65PubMedCrossRef
15.
go back to reference McLouglin J, Jager R, Abel PD, Williams G (1990) The use of prostatic stents in patients with urinary retention who are unfit for surgery. An interim report. Br J Urol 66:66–70CrossRef McLouglin J, Jager R, Abel PD, Williams G (1990) The use of prostatic stents in patients with urinary retention who are unfit for surgery. An interim report. Br J Urol 66:66–70CrossRef
16.
go back to reference Williams G, Coulange C, Milroy EJG, Sarramon JP, Rubben H (1993) The Urolume, a permanently implanted prostatic stent for patients at high risk for surgery. Results from 5 collaborative centres. Br J Urol 72:335–340PubMed Williams G, Coulange C, Milroy EJG, Sarramon JP, Rubben H (1993) The Urolume, a permanently implanted prostatic stent for patients at high risk for surgery. Results from 5 collaborative centres. Br J Urol 72:335–340PubMed
17.
go back to reference Milroy E, Chapple CR (1993) The Urolume stent in the management of benign prostatic hyperplasia. J Urol 150:1630–1635PubMed Milroy E, Chapple CR (1993) The Urolume stent in the management of benign prostatic hyperplasia. J Urol 150:1630–1635PubMed
18.
go back to reference Oesterling JE, Kaplan SA, Epstein HB, Defalco AJ, Reddy PK, Chancellor MB (1994) The North American experience with the UroLume endoprosthesis as a treatment for benign prostatic hyperplasia: long-term results. The North American UroLume Study Group. Urology 44:353–362PubMedCrossRef Oesterling JE, Kaplan SA, Epstein HB, Defalco AJ, Reddy PK, Chancellor MB (1994) The North American experience with the UroLume endoprosthesis as a treatment for benign prostatic hyperplasia: long-term results. The North American UroLume Study Group. Urology 44:353–362PubMedCrossRef
19.
go back to reference Masood S, Djaladat H, Kouriefs C, Keen M, Palmer JH (2004) The 12-year outcome analysis of an endourethral wallstent for treating benign prostatic hyperplasia. BJU Int 94:1271–1274PubMedCrossRef Masood S, Djaladat H, Kouriefs C, Keen M, Palmer JH (2004) The 12-year outcome analysis of an endourethral wallstent for treating benign prostatic hyperplasia. BJU Int 94:1271–1274PubMedCrossRef
20.
go back to reference Shah DK, Kapoor R, Badlani GH (2003) Experience with urethral stent explantation. J Urol 169:1398–1400PubMedCrossRef Shah DK, Kapoor R, Badlani GH (2003) Experience with urethral stent explantation. J Urol 169:1398–1400PubMedCrossRef
21.
go back to reference Armitage JN, Cathcart PJ, Rashidian A, De Nigris E, Emberton M, van der Meulen JH (2007) Epithelializing stent for benign prostatic hyperplasia: a systematic review of the literature. J Urol 177:1619–1624PubMedCrossRef Armitage JN, Cathcart PJ, Rashidian A, De Nigris E, Emberton M, van der Meulen JH (2007) Epithelializing stent for benign prostatic hyperplasia: a systematic review of the literature. J Urol 177:1619–1624PubMedCrossRef
22.
go back to reference Song HY, Cho KS, Sung KB, Han YM, Kim YG, Kim CS (1995) Self-expandable metallic stents in high-risk patients with benign prostatic hyperplasia: long-term follow-up. Radiology 195:655–660PubMed Song HY, Cho KS, Sung KB, Han YM, Kim YG, Kim CS (1995) Self-expandable metallic stents in high-risk patients with benign prostatic hyperplasia: long-term follow-up. Radiology 195:655–660PubMed
23.
go back to reference van Dijk MM, Mochtar CA, Wijkstra H, Laguna MP, de la Rosette JJ (2006) The bellshaped nitinol prostatic stent in the treatment of lower urinary tract symptoms: experience in 108 patients. Eur Urol 49:353–359PubMedCrossRef van Dijk MM, Mochtar CA, Wijkstra H, Laguna MP, de la Rosette JJ (2006) The bellshaped nitinol prostatic stent in the treatment of lower urinary tract symptoms: experience in 108 patients. Eur Urol 49:353–359PubMedCrossRef
24.
go back to reference Yoon CJ, Song HY, Kim JH et al (2010) Temporary placement of a covered, retrievable, barbed stent for the treatment of hormone-induced benign prostatic hyperplasia: technical feasibility and histologic changes in canine prostates. J Vasc Interv Radiol 21:1429–1435PubMedCrossRef Yoon CJ, Song HY, Kim JH et al (2010) Temporary placement of a covered, retrievable, barbed stent for the treatment of hormone-induced benign prostatic hyperplasia: technical feasibility and histologic changes in canine prostates. J Vasc Interv Radiol 21:1429–1435PubMedCrossRef
25.
go back to reference Crisostomo V, Song HY, Maynar M, Sun F, Soria F, Lima JR, Yoon CJ (2007) Evaluation of the effects of temporary covered nitinol stent placement in the prostatic urethra: short-term study in the canine model. Cardiovasc Intervent Radiol 30:731–737PubMedCrossRef Crisostomo V, Song HY, Maynar M, Sun F, Soria F, Lima JR, Yoon CJ (2007) Evaluation of the effects of temporary covered nitinol stent placement in the prostatic urethra: short-term study in the canine model. Cardiovasc Intervent Radiol 30:731–737PubMedCrossRef
Metadata
Title
Placement of retrievable self-expandable metallic stents with barbs into patients with obstructive prostate cancer
Authors
Ho-Young Song
Choung Soo Kim
In Gab Jeong
Dalsan Yoo
Jin Hyoung Kim
Deok Ho Nam
Jae-Ik Bae
Jung-Hoon Park
Publication date
01-03-2013
Publisher
Springer-Verlag
Published in
European Radiology / Issue 3/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-012-2650-8

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