nitinol and Urethral-Obstruction

Topics: Alloys; Follow-Up Studies; Humans; Stents; Urethral Obstruction

Several prostatic stents were developed in the last three decades, none of which were able to provide a real alternative in patients unfit or unwilling to undergo classical prostatic surgeries. In this study, we report the results of the use of a newly developed prostatic stent--the Allium™ Triangular Prostatic Stent (TPS).. The Allium TPS is a highly flexible, nitinol-built polymer-covered stent, which prevents tissue ingrowth and reduces encrustations. Between 2008 and 2014, at two centers (Israel and Turkey), the stent was inserted under local or regional anesthesia in 51 patients with benign prostatic obstruction (BPO) who are unwilling or unfit for surgery. Patients were followed for 12 months from surgery. The primary outcome was symptom improvement as measured by the international prostate symptom score (IPSS) and improvement in peak urinary flow.. Stent insertion was successful in all patients. The mean IPSS decreased from 26.4 to 7.7 on the last follow-up. The mean peak flow increased from 5.5 mL/second before stent insertion to 16.0 mL/second 1 year thereafter. The main adverse effect was transient pain in nine patients. No stent migration or obstruction was seen. Patients reported satisfaction and improvement in quality of life.. Our short-term results show that Allium TPS is safe and effective for the treatment of patients with BPO.

Topics: Aged; Aged, 80 and over; Alloys; Cystoscopes; Endoscopy; Equipment Design; Humans; Israel; Male; Middle Aged; Prostatic Hyperplasia; Quality of Life; Stents; Turkey; Urethral Obstruction

To evaluate the results obtained using a permanent prostatic stent system (Memotherm, Bard/ Angiomed, Karlsruhe, Germany) in high-risk patients with advanced prostatic carcinoma and subvesical obstruction.. The study included 35 patients (mean age 75.3 years, range 53-89) with advanced prostatic carcinoma and persistent subvesical obstruction despite androgen ablation. Because of serious concurrent diseases, 49% of these patients were classified as American Society of Anesthesiologists (ASA) grade 3 and 51% as ASA grade 4. The patients were treated using the Memotherm stent, a thermosensitive Nitinol mesh stent. The outcome was assessed by measuring voiding variables, a symptom score and as the incidence of complications.. After inserting the stent, 33 (94%) of the patients were able to void spontaneously and there was a statistically significant improvement in the voiding variables. These results remained unchanged over a mean (range) follow-up of 15.2 months (3-38). There were no serious complications arising from the insertion of the stent.. For high-risk patients with subvesical obstruction caused by prostatic carcinoma, the insertion of a permanent metal stent system offers a useful alternative treatment to transurethral resection.

Topics: Aged; Aged, 80 and over; Alloys; Humans; Male; Middle Aged; Prostatic Neoplasms; Stents; Urethral Obstruction

The nitinol (shape memory alloy, SMA) spiral was used in 39 patients with benign prostatic hyperplasia (BPH). Caine experiment indicated that the spiral could be embedded by prostatic urethra epithelium in 6 months. The new transitional epithelium between spiral wires was originated from the urethra transitional epithelium as proved by immunohistochemical staining. The parts of spiral project over the bladder cavity formed incrustation on the spiral tip. The nitinol is of super-elastic property, corrosive-resistance and excellent biocompatibility, in addition to unique shape memory effect. We treated 39 patients with BPH by self-made coaxial sheath introducing Chinese nitinol spiral into the prostatic urethra, with a successful rate of 89.7%. Follow-up for 3-26 months showed no incrustation and migration of the spiral.

Topics: Aged; Aged, 80 and over; Alloys; Animals; Dogs; Humans; Male; Middle Aged; Nickel; Prostatic Hyperplasia; Stents; Titanium; Urethral Obstruction