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Thermo-expandable stent for BPH seem safe

Thermo-expandable stent for BPH seem safe. 史精华 2001 级临床 7 年制 3 班. General introduction of BPH Thermo-expandable stents for BPH Advantages and disadvantages My view and prospect. BPH (benign prostatic hypertrophy). A common condition affecting elderly men

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Thermo-expandable stent for BPH seem safe

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  1. Thermo-expandable stent for BPH seem safe 史精华 2001级临床7年制3班

  2. General introduction of BPH • Thermo-expandable stents for BPH • Advantages and disadvantages • My view and prospect

  3. BPH(benign prostatic hypertrophy) • A common condition affecting elderly men • A benign enlargement of prostatic tissue • Incidence increased with age • Lead to LUTS obstructive (lower urinary tract symptoms) irritative picture

  4. Treatment modalities • Watchful waiting • Drug therapies • New minimally invasive techniques • Surgen • Prostatic stents

  5. Thermo-expandable stent for BPH Eg:Memokath • Metal(nickel-titanium alloy) spiral stent • With a thermal memory for a predetermined connfiguration • Flush warm water to expand with the distal portion preventing migratrion • Remove by flushing with cold water • Placed or retrieved with cystoscope,under local anaesthesia

  6. Advantage • Prostatic stenting is a successful definitive or temporary treatment for symptomatic bladder outlet obstruction due to BPH • Simply inserted under local anasthesia in an out-patient enviroment • Allow spontaneous voiding immediately in most patients

  7. Disadvantage • Heavy burden on healthcare resources • Complications stent migration stent encrustation long term efficacy is sparce

  8. Potential advantages of minimally invasive procedures for bph

  9. Potential disadvantages

  10. 《Thermo-expandable intra-prostatic stent in the treatment of acute urinary retention in elderly patients with sinificant co-morbilities》 • 15 men with acute urinary retention with mean age of 87 with significant co-morbidities • 3 patients died after insertion with stents in situ • 9 patients had good functioning stents post-operatively,and remain catheter free up to 30 month • 3 longterm complications were detected • No peri-operative complications recorded ----------BJU 20O3 JULY 812-814

  11. 《The thermo-expandable metallic stent for managing benign prostatic hyperplasia》 • 14 case series described the use of the stent in 839 men with BPH • Treatment failure rates were 0-48% but duration of follow-up not clear • 5 studies reported the reductions of 11-19 points(IPSS)after stent insertion • 7 studies found max urinary flow rates increased • 4 studies described residual urine volumes decreased ----------BJU 2006 oct(87 )810-818

  12. 《Ease of removal of the thermo-expandable prostate stents》 • 93 patient at three reporting centres had stents removed • Mean indwelling time 12.9months • Topical anaesthesia or no anaesthesia 48% • 9% described moderate discomfort or worse • Procedure 11min • Felt easy or fairly easy in 90% ----------BJU 2005 (96)578-580

  13. My view The memokath stent can provide an effective treatment for BPH in men at high operative risk;it also appears to be safe,but inadequate follow up dosen’t allow firm conclusions on stent durability.

  14. prospect • Convenient • Durable • Cheap(eapecially homemade) • Biologic material

  15. THANK YOU

  16. Normal prostate prostate with BPHback

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