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Stents - Help for Men with Urinary Problems



Cardiologists use "stents" to keep open obstructing coronary arteries. These stents are made of materials that are basically a woven tunnel which are placed using x-ray control within the blocked vessels of the heart. Urology deals also with problems of obstruction, and in particular, obstruction from prostate disease and obstruction from stricture disease of the urethra.

In the past, enlargement of the prostate which occurs in 50 percent of men over 50 years frequently leads to either medications or surgery due to the symptoms of obstruction: decreased stream, intermittency of urination, frequently waking up at night to void, frequency, urgency, control problems, and in many cases actual retention of urine. The Food and Drug Administration authorized the utilization of a "stent" manufactured by American Medical Systems called the Urolume which when placed, presses against the sidewalls of the prostate keeping the ever- growing and obstructing prostate away from the tube through which urine passes and therefore decreasing obstruction and the associated symptoms.

The prostate is a gland surrounding the neck of the bladder and the urethra. The tube that passes through is the urethra and that segment is called the prostatic urethra. As the prostate gets larger, it grows inward and blocks the prostatic urethra causing obstruction.

The Urolume is composed of a super alloy made of approximately eight different nonmagnetic metals which are finely woven to form a tube-like structure that constantly presses against the sidewalls of the prostate keeping the prostatic urethra open. The insertion procedure is usually done in less than 15 minutes.

It involves mild anesthesia, no cutting, no blood loss, and no hospital stay. The patient leaves the "in and out" surgical area without a catheter and with immediate symptom relief. In approximately two months the lining of the prostatic urethra and prostate begins to grow over and include the Urolume into its substance. Usually within six months to one year the entire Urolume is covered by lining tissue.

If not successful the Urolume can easily be removed and other prostate obstructive procedures can be performed. Problems include mild discomfort in the perineal area which usually relieves in several weeks and if not is usually due to poor placement of the device. On rare occasions, if the device is not completely placed within the prostatic urethra, stones may form on the exposed Urolume and additional procedures may be necessary.

The Urolume can be used to keep strictures of the urethra open as well. Many patients who have had gonorrhea, trauma to the urethra, multiple manipulations and long-term catheterizations of the urethra for various reasons can develop a chronic infection of the wall of the urethra with subsequent scar tissue and with contraction of the scar tissue a stricture which is a narrowing of the urethra.

This causes significant obstruction and with the obstruction decreased flow, urgency, and frequency. These problems in the past have been handled with dilating the stricture, i.e. making them bigger by stretching, or cutting the stricture under direct vision, i.e. direct vision urethrotomy.

In many cases the strictures recur and repeat procedures are necessary multiple times over in the course of time. In those patients, however, who need repeat procedures because of recurrent strictures and their associated symptoms of obstruction, urgency, and frequency, and in some cases purulent discharge, urethral bleeding, etc., the Urolume can be utilized to keep the stricture site open and stop not only the symptoms but the recurrence of the disease.

At this time the Urolume should only be used in strictures of the bulbar urethra which is that section of the urine tube closest to the prostate but not in the prostate.

When used for urethral strictures the stricture site must first be opened by dilatation or urethrotomy, a proper length stent positioned, and usually positioned slightly larger than the stricture itself appears to be. This stent also becomes incorporated into the stricture and holding the walls of the stricture away from the urethra therefore inhibiting the stricture from obstructing and growing into the urethral tube.

Modern biotechnology has been able to use stenting materials to keep open blood vessels including blood vessels of the leg and of the heart. This same technology is starting to be used in the urinary tract both to diminish the obstruction of benign prostatic enlargement, a common disease among men, and chronic recurrent stricture disease of the urethra as well. This new technology effectively replaces other procedures without major surgery or anesthesia allowing in and out admission, requiring no blood loss, and requiring no long-term catheterizations.

These procedures take less than fifteen minutes. The patient can be discharged from an in and out facility or surgery center within hours and feel the anti-obstruction effects of the device almost immediately. Problems and complications are rare and unusual and effectiveness is very high.

The alternatives to surgery in the case of benign enlargement have many disadvantages and in the case of medical therapy the disadvantages include poor response, cost factors, i.e. taking drugs for the rest of your life, significant side effects of chronic medication intake such as weakness, tiredness, and retrograde ejaculation. With symptomatic benign prostatic hypertrophy sufferers may wish to consider using the Urolume versus the other alternatives. With chronic recurrent stricture disease your alternatives are minimal and you should seriously consider this effective form of therapy. Check with your health care provider.