The thermo-expandable metallic stent for managing benign prostatic hyperplasia: a systematic review.


Armitage, JN; Rashidian, A; Cathcart, PJ; Emberton, M; van der Meulen, JH; (2006) The thermo-expandable metallic stent for managing benign prostatic hyperplasia: a systematic review. BJU international, 98 (4). pp. 806-10. ISSN 1464-4096 DOI: https://doi.org/10.1111/j.1464-410X.2006.06399.x

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Abstract

OBJECTIVES To systematically review published reports of the safety, effectiveness and durability of a self-expanding metallic prostatic stent (Memokath((R)), Engineers & Doctors A/S Ltd., Denmark) in patients with benign prostatic hyperplasia (BPH) who are unfit for surgery. METHODS We systematically searched the Medline and Embase databases from 1992. The reference lists of included studies and the bibliographies of review articles were also searched. We contacted the manufacturer of Memokath for additional information. The primary outcomes were treatment failure (stent removal, replacement or repositioning) and urological symptom scores. Secondary outcomes were urodynamic indices and minor complications. Two reviewers independently assessed the methodological quality of the studies and extracted data. Data were synthesized using narrative techniques. RESULTS In all, 14 case series described the use of the Memokath stent in 839 men with BPH. All patients were at high operative risk. Most studies were of poor quality with an inadequate follow-up. Treatment failure rates were 0-48% but the duration of follow-up was often unclear. Five studies reported International Prostate Symptom Scores and found reductions of 11-19 points after stent insertion. All seven studies that reported on maximum urinary flow rates found that these increased, and the four that described residual urine volumes found that these decreased. Minor complications were inconsistently reported. CONCLUSIONS The Memokath stent can provide an effective treatment for BPH in men at high operative risk; it also appears to be safe, but inadequate follow-up does not allow firm conclusions on stent durability.

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Health Services Research and Policy
PubMed ID: 16879446
Web of Science ID: 240349000021
URI: http://researchonline.lshtm.ac.uk/id/eprint/11092

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