Evaluation of the Effects of Temporary Covered Nitinol Stent Placement in the Prostatic Urethra: Short-Term Study in the Canine Model |
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Authors: | Verónica Crisóstomo Ho Young Song Manuel Maynar Fei Sun Federico Soria Juan Rafael Lima Chang Jin Yoon Jesús Usón-Gargallo |
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Institution: | (1) Minimally Invasive Surgery Center, Avda. de la Universidad, s/n Campus Universitario, 10071 Cáceres, Spain;(2) Asan Medical Center, University of Ulsan Collage of Medicine, 388-1 Poongnap-dong, Songpa-gu Seoul, 138-736, Republic of Korea;(3) Universidad de Las Palmas de Gran Canaria, c/ Juan de Quesada, no. 30, 35001 Las Palmas de Gran Canaria, Spain;(4) Department of Radiology, Bundang Hospital Seoul, Republic of Korea, National University 300 Gumidong, Bundang-gu, Seongnam-si Gyeonggi-do, 463-707, Republic of Korea |
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Abstract: | Purpose To evaluate the effect of temporary stent placement on the canine prostatic urethra.
Methods Retrievable PTFE-covered nitinol stents were placed in the prostatic urethras of 8 beagle dogs under fluoroscopic guidance.
Retrograde urethrography was obtained before and after stenting. Retrograde urethrography and endoscopy were performed 1 and
2 months after deployment. The endoscopic degree of hyperplasia was rated on a scale of 0 to 4 (0 = absence, 4 = occlusion).
On day 60, stents were removed and urethrography was performed immediately before euthanasia. Pathologic analysis was performed
to determine the degree of glandular atrophy, periurethral fibrosis, and urethral dilation.
Results Stent deployment was technically successful in 7 animals, and failed in 1 dog due to a narrow urethral lumen. Complete migration
was seen in 2 animals at 1 month, and an additional stent was deployed. On day 30, endoscopy showed slight hyperplasia (grade
1) in 3 animals. On day 60, moderate hyperplasia (grade 2) was evidenced in 4 cases. No impairment of urinary flow was seen
during follow-up. Retrieval was technically easy to perform, and was successful in all dogs. The major histologic findings
were chronic inflammatory cell infiltrates; prostate glandular atrophy, with a mean value of 1.86 (SD 0.90); periurethral
fibrosis, with a mean ratio of 29.37 (SD 10.41); and dilatation of the prostatic urethra, with a mean ratio of 6.75 (SD 3.22).
Conclusion Temporary prostatic stent placement in dogs is safe and feasible, causing marked enlargement of the prostatic urethral lumen.
Retrievable covered stents may therefore be an option for bladder outlet obstruction management in men. |
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Keywords: | Experimental study Prostate stent Retrievable stents |
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