PD26-08 THERMO-EXPANDABLE METALLIC URETHRAL STENT FOR MANAGING ELDERLY PEOPLE WITH INDWELLING URINARY CATHETER: A COMPELLING OPTION TO AVOID LONG-TERM CATHETERIZATION

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You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence: Therapy I1 Apr 2018PD26-08 THERMO-EXPANDABLE METALLIC URETHRAL STENT FOR MANAGING ELDERLY PEOPLE WITH INDWELLING URINARY CATHETER: A COMPELLING OPTION TO AVOID LONG-TERM CATHETERIZATION Cyrielle Rambaud, Sébastien Gonfrier, Cyprien Arlaud, Laetitia Imbert de la Phalecque, Jérémy Fallot, Romain Haider, Brannwel Tibi, Olivier Guérin, and Matthieu Durand Cyrielle RambaudCyrielle Rambaud More articles by this author , Sébastien GonfrierSébastien Gonfrier More articles by this author , Cyprien ArlaudCyprien Arlaud More articles by this author , Laetitia Imbert de la PhalecqueLaetitia Imbert de la Phalecque More articles by this author , Jérémy FallotJérémy Fallot More articles by this author , Romain HaiderRomain Haider More articles by this author , Brannwel TibiBrannwel Tibi More articles by this author , Olivier GuérinOlivier Guérin More articles by this author , and Matthieu DurandMatthieu Durand More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1347AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Management of chronic urinary retention in elderly people is challenging and time consuming, leading to high risk to place indwelling urinary catheter (IUC). The use of urethral stent (045-TW Memokath) may be an option in selected patients to avoid long-term catheterization. We assess the efficacy and treatment-related complications in such maintaining urethral patency. METHODS All patient over 70 yo with failed removal of long-term urinary catheter were proposed to a multidisciplinary decision-making. Alternative treatment (AT) was offered after decision process. Urethral stent was indicated for treatment of patients with severe IUC-associated urethral injury and re-current or permanent bladder neck obstruction but unfit for long general anesthesia. All patients were followed using plain radiography, uroflowmetry and urine analysis. RESULTS 118 patients were enrolled with a mean age of 86.4 yo (women: 33.2%). AT were offered to 62.7% (n=74), including 18 urethral stents, 30 catheter withdrawals, 22 photovaporizations of the prostate, 2 prostatic artery embolizations and 2 other surgeries. Overall, the success rate was 89.2% at 7 days and raised up to 92% at 1month. Among the 80 men, an AT was performed in 53 men including 18 urethral stents. Clinical characteristics men who received urethral sents compared to others are presented table 1. The success rate of urethral stent, at 7 days, was 94.5%, with one stent removed for a retention. In all, 10 stents were still functioning at the end of follow-up after a mean 175 days [40-434]. Six patients had died of reasons unrelated to the stent with a functioning stent in situ after an average of 58 days. One stent was removed after 192 days due to an infection. No other serious infections or stent migrations has been reported. Residual urine was <200ml after placement of the stents. CONCLUSIONS In our cohort, urethral stents allowed to 94.4% of frailty patients to avoid an IUC. Urethral stents are indicated for frailed patients with a risk to tear off their catheters. This alternative option to IUC may allow to improve autonomy and quality of life. More data are needed, to confirm the safety and the efficacy of this technic. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e554-e555 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Cyrielle Rambaud More articles by this author Sébastien Gonfrier More articles by this author Cyprien Arlaud More articles by this author Laetitia Imbert de la Phalecque More articles by this author Jérémy Fallot More articles by this author Romain Haider More articles by this author Brannwel Tibi More articles by this author Olivier Guérin More articles by this author Matthieu Durand More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...