Cambio Angelo J, Roach Richard M, Arnold Paul, Cambio Joseph, Gluck Clifford D, Heron Sean P
Brown Urology Brown Physicians, West Warwick, RI, USA.
Advanced Urology Institute, Oxford, FL, USA.
Adv Urol. 2022 Feb 3;2022:7367851. doi: 10.1155/2022/7367851. eCollection 2022.
This US FDA investigational device exemption (IDE) study evaluated the extended use of The Spanner® Temporary Prostatic Stent in catheter-dependent men with urinary retention who were not deemed candidates for corrective surgery but demonstrated bladder contractility.
The Spanner was placed for 3 cycles of 30 days in catheter-dependent men with comorbid conditions, confirmed detrusor contractility, and catheter-associated discomfort. At each visit, postvoid residual, maximum flow rate, international prostate symptom score, quality of life, and adverse events were assessed. Voiding success was defined as PVR ≤ 150 ml at all visits.
One hundred seven men were enrolled at 8 US sites; 82/107 (76.6%) completed the trial, and 79/107 (73.8%) successfully maintained PVR ≤ 150 ml for the trial duration. Patients were 77.1 ± 10.6 years old; 63/107 (58.9%) were dependent on Foley and 40/107 (37.4%) on intermittent catheterization for 36.0 ± 39.3 days and 30.2 ± 45.8 days, respectively. 25/107 (23.4%) discontinuations were primarily due to voluntary patient withdrawal 9/107 (8.4%), investigator-initiated withdrawal 8/107 (7.5%), or lack of effectiveness 4/107 (3.7%). During Spanner use, the mean was 11.2 ± 6.6, mean IPSS was 7.5 ± 6.4, and mean QOL was 2.0 ± 1.6. The most prevalent device-related adverse events were asymptomatic bacteriuria 25/107 (23.4%), discomfort 10/107 (9.4%), and urinary urgency 8/107 (7.5%). No device-related serious AEs were reported.
This study demonstrates that catheter-dependent men with sufficient bladder contractility can achieve volitional voiding and successful bladder drainage using The Spanner Temporary Prostatic Stent for extended periods of time.
本美国食品药品监督管理局(FDA)研究性器械豁免(IDE)研究评估了Spanner®临时前列腺支架在因尿潴留而依赖导尿管且不被认为适合进行矫正手术但显示膀胱收缩力的男性中的长期使用情况。
将Spanner放置在患有合并症、经确认有逼尿肌收缩力且伴有导尿管相关不适的依赖导尿管的男性体内,放置3个周期,每个周期30天。每次就诊时,评估残余尿量、最大尿流率、国际前列腺症状评分、生活质量和不良事件。排尿成功定义为每次就诊时残余尿量≤150毫升。
在美国8个地点招募了107名男性;82/107(76.6%)完成了试验,79/107(73.8%)在试验期间成功维持残余尿量≤150毫升。患者年龄为77.1±10.6岁;63/107(58.9%)依赖Foley导尿管,40/107(37.4%)依赖间歇性导尿,分别为36.0±39.3天和30.2±45.8天。25/107(23.4%)的停药主要是由于患者自愿退出9/107(8.4%)、研究者发起的退出8/107(7.5%)或缺乏有效性4/107(3.7%)。在使用Spanner期间,平均[此处原文缺失具体指标]为11.2±6.6,平均国际前列腺症状评分(IPSS)为7.5±6.4,平均生活质量(QOL)为2.0±1.6。最常见的与器械相关的不良事件是无症状菌尿25/107(23.4%)、不适10/107(9.4%)和尿急8/107(7.5%)。未报告与器械相关的严重不良事件。
本研究表明,膀胱收缩力足够的依赖导尿管的男性使用Spanner临时前列腺支架可长时间实现自主排尿和成功的膀胱引流。