Stents for Prostatic Diseases: Any Progress after 25 Years?

Abstract

The use of an endoprosthesis to maintain luminal patency is a well-established concept in a variety of surgical settings, including cardiovascular and gastrointestinal pathologies. First reports on the use of prostatic stents were published in the 1980s for benign prostatic obstruction (BPO). In this issue of European Urology van Dijk and associates from Amsterdam report on the use of a bell-shaped Nitinol prostatic stent in 108 elderly men with lower urinary tract symptoms (LUTSs) due to BPO in an elective setting [1]. The authors concluded that ‘‘Because of the limited durability, however, the bell-shaped prostatic stent is not suitable for clinical practice’’ [1]. Based on this most recent, large-scale study, one is attempted to close this editorial with the definite conclusion that no relevant progress has been made over the past 25 yr and that prostatic stents—at least in their current form—are clinically not useful. However, the diversity of stent designs and indications justifies a more differentiated view. In general, prostatic stents are divided into permanent and temporary devices [2]. The major characteristic of permanent prostatic stents is that they allow tissue ingrowth that results in the stent being embedded in the urethral wall; the most frequently used permanent stents are the UroLume and the Memotherm devices [2]. These stents were initially introduced for the management of recurrent urethral strictures. Several problems are common to permanent stents such as encrustation, urinary tract infection (UTI),