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1. Metallic: First Generation: Urospiral (Fabian,1980). Second: Prosta-Coil (Self-expanding). Memo-kath (Thermal expanding). Third Generation: Memo-kath 028 (Memory)

2. Plastic Stents: The Spanner  (Temporary)

3. Biodegradable Stents: Poly-glycolic Acid: By time degraded  to CO2 and water. No need for removal. 

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Prostatic Stents Contra-indications:    

Relative contraindications to the procedure include:

  1. Meatal and urethral strictures
  2. Active urinary tract infection (UTI)
  3. Haematuria and patients on anti-coagulants that prevents adequate visualisation for placement
  4. Bladder calculi
  5. A large Prostatic median lobe that hampers satisfactory placement
  6. Bladder neck stenosis
  7. A prostatic urethra shorter than 2cm (Fibrous prostate) as the least product length is 3 Cm.

Complications of Prostatic Stents:

  • As with any surgical procedure there are potential complications, which can include: perineal discomfort, light bleeding, post-void dribbling. These complications are common and usually subside after few days.
  • More serious complications can include: Stent migration into the distal urethra or bladder, encrustation and stone formation on the stent that can obstruct the lumen.

Indications and exclusion criteria:

  1. Included severe respiratory and cardiovascular disease.
  2. Excluded bladder carcinoma and prostatic carcinoma, calculi or detrusor failure
  3. Normal coagulation profile (Aspirin and Plavix are to be stopped for a week prior to the procedure)
  4. Warfarin has to be replaced with low molecular wt. Heparin and stopped 12 hours prior to the procedure 

Conclusion:

The Memo-kath intra-prostatic stent is a valuable addition to the armamentarium of the urologist treating elderly men with advanced bladder outlet obstruction and associating major contra-indications for general and regional anaesthesia.

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