Management of benign prostatic hyperplasia in high risk patients: Long-term experience with the Memotherm stent

Purpose: Of all patients with benign prostatic hyperplasia (BPH) 10 to 15% cannot undergo surgery due to grave concomitant diseases. Successful treatment should avoid catheterization to maintain quality of life. We report on our long-term experience with the Memotherm* stent implanted in high risk patients with BPH. Materials and Methods: The Memotherm stent is made of self expanding thermosensitive nitinol, and it is implanted into the prostatic urethra using endoscopic control. Due to its shape memory the stent reaches maximum size at body temperature. The method of implantation is minimally invasive and the treatment can be done with the patient under spinal or intravenous anesthesia. From March 1993 to December 1996 we implanted the Memotherm stent in 123 high risk patients. To assess the long-term effects we performed followups up to 48 months after implantation. As a measure of the efficacy of the stent we documented urinary flow and residual urine. To assess voiding symptoms and quality of life we used the International Prostate Symptom Score. Results: Implantation of the Memotherm stent led to a decrease of residual urine from a mean of 153.7 to 26.0 ml. and to an increase of urinary flow from 7.4 to 16.1 ml. per second. Patients had fewer voiding problems and noticed an increase in quality of life. The success of this therapy remained high during followup. Conclusions: Treatment with the Memotherm stent offers a good alternative therapy for high risk patients with BPH.