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[前列腺梗阻的长期临时假体。ProstaCoil,一种大口径可扩张、自固定植入物]

[Long-term temporary prosthesis in prostatic obstruction. ProstaCoil, an expanding, self-fixating implant of large caliber].

作者信息

Yachia D

机构信息

Department of Urology, Hillel Yaffe Medical Center, Hadera, Israël.

出版信息

J Urol (Paris). 1993;99(6):328-31.

PMID:7516381
Abstract

The spiral metallic stent for insertion into the prostatic urethra developed by Fabian a decade ago, and its various modifications have a fixed external caliber of up to 21F and does not allow passage of instruments larger than 5-6F through it. Thus, they cannot be used in patients who need frequent trans-urethral manipulations. Since all temporary prostatic stents, in the long term develop incrustations they have to be changed once a year, or earlier, if they become occluded by stone formation. Permanent stents cannot be used in patients who are temporarily unfit for surgery because their removal necessitate traumatic manipulations. In order to overcome these disadvantages, a new large caliber, self-expanding and self-retaining intra-prostatic stent was developed (ProstaCoil). This stent is inserted under fluoroscopic guidance using topical anaesthesia. During the last 36 months the ProstaCoil was inserted into 65 patients suffering from complete prostatic obstruction due to BPH. Follow-up of our patients was 3-28 months (mean 16 months). Forty-eight patients could void either immediately or within 48 hours after insertion of the stent. Thirty patients underwent TURP or open prostatectomy 3-12 months after insertion of the stent. In all these cases the stent was removed easily before surgery. Only in 1 case the stent was removed because of severe urge incontinence. Seven patients died during this period. Twenty-seven patients still are passing urine through their stents (the longest 32 months).

摘要

法比安在十年前研发的用于插入前列腺尿道的螺旋金属支架及其各种改良型产品,其外部口径固定最大为21F,不允许大于5 - 6F的器械通过。因此,它们不能用于需要频繁经尿道操作的患者。由于所有临时性前列腺支架长期都会形成结痂,所以必须每年更换一次,或者如果被结石堵塞则需更早更换。永久性支架不能用于暂时不适合手术的患者,因为取出它们需要进行有创操作。为了克服这些缺点,研发出了一种新型的大口径、可自扩张且可自固定的前列腺内支架(ProstaCoil)。该支架在局部麻醉下于透视引导下插入。在过去36个月里,ProstaCoil被插入65例因良性前列腺增生导致完全性前列腺梗阻的患者体内。对这些患者的随访时间为3 - 28个月(平均16个月)。48例患者在支架插入后立即或48小时内能够排尿。30例患者在支架插入后3 - 12个月接受了经尿道前列腺切除术(TURP)或开放性前列腺切除术。在所有这些病例中,手术前支架都很容易被取出。仅1例患者因严重急迫性尿失禁而取出了支架。在此期间有7例患者死亡。27例患者仍通过支架排尿(最长达32个月)。

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