NEW BPH TREATMENTS, AND HOW TO EVALUATE THEM : RESULTS AND COMPLICATIONS

Results. Long-term results with permanent stents are not available. Temporary stents made of nickel alloy appear to be well tolerated, with few problems of becoming encrusted with stones. The permanent stents made of nickel-titanium alloy have been used for both the treatment of BPH and of urethral strictures. These also appear to be associated with fewer problems such as encrustation and urinary tract infection.

Complications with the stents are few and, in most cases, seem to resolve themselves over time. Most men experience irritative symptoms—some incontinence, a sense of urgency to urinate, and a need to urinate frequently— and some discomfort in the perineum for days to weeks after the operation. Anticholinergic drugs may be prescribed to help slow a too-frequent need to urinate. A few men in one study reported painful ejaculation the first time they had sex after the operation, but this went away with later sexual activity.

Sometimes the stents don’t work out—if the irritative symptoms persist, or if the epithelial cells fail to cover the tubes adequately, causing them to become clogged. In these and other studies, when this happened the stents were removed intact, without harming the urethra or the bladder’s external urinary sphincter. Stents can also be repositioned, and sometimes just a slight adjustment in their placement can resolve such symptoms as incontinence and urinary retention.

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