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Volume 177, Issue 3, Pages 1040-1046 (March 2007)


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A Temporary Intraurethral Prostatic Stent Relieves Prostatic Obstruction Following Transurethral Microwave Thermotherapy

Neal D. ShoreaCorresponding Author Informationemail address, Martin K. Dineenb, Mark J. Saslawskyc§, Jeffrey H. Lumermand, Alberto P. Coricae§

Received 8 July 2006

Purpose

The Spanner™, a novel prostatic stent, was evaluated for safety, efficacy and patient tolerance when used to relieve prostatic obstruction following transurethral microwave thermotherapy.

Materials and Methods

Following transurethral microwave thermotherapy and routine post-procedure Foley catheterization at 1 of 9 clinical sites 186 patients meeting study criteria were randomized to receive a Spanner (100) or the standard of care (86). Baseline evaluations included post-void residual urine, uroflowmetry, International Prostate Symptom Score and International Prostate Symptom Score quality of life question. These evaluations were repeated at visits 1, 2, 4, 5 and 8 weeks after randomization (Spanner insertion) with the addition of the Spanner satisfaction questionnaire, ease of use assessment and adverse events recording. The Spanner was removed after 4 weeks, at which time the Spanner and standard of care groups underwent cystourethroscopy.

Results

At the 1 and 2-week visits the Spanner group showed significantly greater improvements from baseline in post-void residual urine, uroflowmetry and International Prostate Symptom Score compared to the standard of care group. The Spanner group experienced significantly greater improvements in quality of life at the 5 and 8-week visits. Patient satisfaction with the Spanner exceeded 86%. Cystourethroscopy findings in the Spanner and standard of care groups were comparable and adverse events associated with previous stents were rare.

Conclusions

The Spanner is a safe, effective and well tolerated temporary stent for severe prostatic obstruction resulting from therapy induced edema after transurethral microwave thermotherapy. It may be a needed addition to the armamentarium for managing bladder outlet obstruction in a broad group of urological patients.

a Grand Strand Urology, Myrtle Beach, South Carolina

b Atlantic Urology Associates, Daytona Beach, Florida

c Southeast Urology Network, Memphis, Tennessee

d Urological Surgeons of Long Island, Garden City, New York

e Instituto Urologico De Guayama, Guayama, Puerto Rico

Corresponding Author InformationCorrespondence: 823 82nd Parkway, Myrtle Beach, South Carolina 29572 (telephone: 843-449-1010; FAX: 843-286-0119).

 Financial interest and/or other relationship with AbbeyMoor Medical, Inc., Dendreon, Boston Scientific and Oncura.

 Financial interest and/or other relationship with Endocare, AbbeyMoor Medical, Inc., Mentor, Sanofi, Genomics, QLT, AstraZeneca, GlaxoSmithKline, GTX, Amgen, National Cancer Institute-Johns Hopkins, Nymox, Schering-Plough.

§ Financial interest and/or other relationship with AbbeyMoor Medical, Inc.

PII: S0022-5347(06)02741-8

doi:10.1016/j.juro.2006.10.059


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