Yachia D, Aridogan I A
Department of Urology, Hillel Yaffe Medical Center, Hadera, Israel.
Urol Int. 1996;57(3):165-9. doi: 10.1159/000282903.
In this study our aim was to compare a first-generation intraprostatic stent (Prostakath) with a second-generation one (ProstaCoil) in patients with prostatic obstruction. The comparison was made in terms of ease of insertion, need for repositioning, migration, infection, stone formation and length of time in place. One hundred and seventeen patients with an age range of 52-94 years were included in this study. Forty-nine of the patients were treated with gold-plated stainless-steel-made stent (Prostakath) inserted under sonographic and 68 of the patients were treated with a nitinol-made stent (ProstaCoil) inserted under fluoroscopic guidance. Indications for stent insertion were similar for both groups. We found that immediate correct positioning was 83% for the Prostakath and 100% for the ProstaCoil. In 42% of the cases the Prostakath necessitated later repositioning because of partial migration and in 12% of the cases removal because of complete migration into the bladder or the anterior urethra. No migration was observed with the ProstaCoil. In 10% of these cases the Prostakath could not be inserted because of the instability of the stent. Due to its larger caliber the second-generation stent caused more transient irritative symptoms. No difference was found in stent-induced infections (10% for all stents). Encrustations were found in 40% of the patients at 1 year with the Prostakath, but in 30% with the ProstaCoil at 2 years. Maximal indwelling time was 12 months with the Prostakath and 36 months with the ProstaCoil. We conclude that the second-generation stent was more advantageous because of its larger caliber allowing catheterization and endoscopic examinations, more flexibility and much longer indwelling time.
在本研究中，我们的目的是比较第一代前列腺内支架（Prostakath）和第二代前列腺内支架（ProstaCoil）在前列腺梗阻患者中的应用情况。比较内容包括插入的难易程度、重新定位的必要性、移位、感染、结石形成以及在位时间。本研究纳入了117例年龄在52至94岁之间的患者。其中49例患者接受了在超声引导下插入的镀金不锈钢制成的支架（Prostakath）治疗，68例患者接受了在荧光透视引导下插入的镍钛合金制成的支架（ProstaCoil）治疗。两组患者的支架插入适应证相似。我们发现，Prostakath的即时正确定位率为83%，ProstaCoil为100%。在42%的病例中，Prostakath因部分移位需要后期重新定位，在12%的病例中因完全移入膀胱或前尿道而需要取出。ProstaCoil未观察到移位情况。在10%的这些病例中，由于支架不稳定，Prostakath无法插入。由于第二代支架口径较大，导致更多的短暂刺激性症状。在支架引起的感染方面未发现差异（所有支架均为10%）。使用Prostakath的患者在1年时有40%出现结壳，而使用ProstaCoil的患者在2年时有30%出现结壳。Prostakath的最长留置时间为12个月，ProstaCoil为36个月。我们得出结论，第二代支架更具优势，因为其口径较大，便于导尿和内镜检查，更具柔韧性，留置时间更长。
