Yoon Chang Jin, Song Ho-Young, Shin Ji Hoon, Woo Chul-Woong, Ro Jae-Y, Park Hyung Keun, Yoon Hyun-Ki
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap-2dong, Songpa-gu, Seoul, Republic of Korea.
J Vasc Interv Radiol. 2006 Nov;17(11 Pt 1):1813-9. doi: 10.1097/01.RVI.0000243613.28211.00.
To evaluate the feasibility of use of a covered, retrievable prostatic urethral stent and to determine urethrographic and histologic changes in the prostate induced by the stent in a canine model.
Polytetrafluoroethylene-covered retrievable nitinol stents were placed in the normal prostatic urethras of 13 dogs. The stents were removed 8 weeks after placement. The dogs were killed immediately after stent removal (group 1, n = 5) or 8 weeks after stent removal (group 2, n = 8). Retrograde urethrograms were obtained every 2 weeks after stent placement and after stent removal in dogs that had not been killed. The histologic changes in the prostate were compared between the two groups.
Stent placement was technically successful in all dogs. In two dogs, a second stent was placed because of migration of the first stent into the urinary bladder. Stent removal was successful in 12 dogs. One stent was removed in its expanded state. On follow-up urethrograms, dilation of the prostatic urethra persisted until animals were killed (P = .14). The mucosal hyperplasia that occurred after stent placement at both ends of the stent gradually decreased after stent removal (P < .001). Histologic examination revealed prostate glandular atrophy and periurethral fibrosis, which did not differ between the two groups (P = .72 and P = .83, respectively). Papillary hyperplasia of the uroepithelium and submucosal inflammatory cell infiltration was decreased significantly in group 2 compared with group 1 (P = .002, P = .011, respectively).
Covered retrievable prostatic urethral stents seem to be feasible for use in the canine prostatic urethra. The stent-induced prostatic urethral dilation and prostate glandular atrophy persist until 8 weeks after stent removal.
评估使用覆膜可回收前列腺尿道支架的可行性,并确定该支架在犬模型中引起的前列腺尿道造影和组织学变化。
将聚四氟乙烯覆膜的可回收镍钛合金支架置入13只犬的正常前列腺尿道。支架置入8周后取出。在支架取出后立即处死犬(第1组,n = 5)或在支架取出8周后处死犬(第2组,n = 8)。对于未处死的犬,在支架置入后和取出后每2周进行逆行尿道造影。比较两组前列腺的组织学变化。
所有犬的支架置入在技术上均获成功。2只犬因第一个支架移入膀胱而置入了第二个支架。12只犬的支架取出成功。一个支架在扩张状态下被取出。在随访尿道造影中,前列腺尿道扩张持续至动物被处死(P = 0.14)。支架置入后在支架两端出现的黏膜增生在支架取出后逐渐减轻(P < 0.001)。组织学检查显示前列腺腺萎缩和尿道周围纤维化,两组之间无差异(分别为P = 0.72和P = 0.83)。与第1组相比,第2组尿路上皮乳头样增生和黏膜下炎性细胞浸润明显减轻(分别为P = 0.002,P = 0.011)。
覆膜可回收前列腺尿道支架似乎可用于犬前列腺尿道。支架引起的前列腺尿道扩张和前列腺腺萎缩在支架取出后持续至8周。