Although transurethral resection of the prostate (TURP) is currently gold standard treatment of benign prostatic hyperplasia (BPH), several complications can be occurred in patients with significant comorbidities. Thus, we assess the efficacy of the thermo-expandable intra-prostatic stent (MemokathTM028, Pnn Medical, Kvistgaard, Denmark) for benign prostatic hyperplasia (BPH) patients with significant comorbidities compared to transurethral resection of the prostate (TURP).

From January 2016 to December 2017, a total of 82 patients who underwent TURP (n=52) or MemokathTM028 stent insertion (n=30) for BPH were included in this study. Patients who underwent MemokathTM028 stent insertion were either permanently or temporarily unfit for TURP; severe respiratory and cardiovascular disease. Follow-up assessments were included International Prostate Symptom Score (IPSS), uroflowmetry, and post-voided residual urine (PVR) at 3, 6, 12, and 24 months after surgery. The differences between preoperative and postoperative parameter were compared using paired t-test.

The mean age was 70.1±6.3 and 79.3±8.4 years in the MemokathTM028 stent insertion and TURP group. The American Society of Anesthesiologists (ASA) scores were significantly higher in the MemokathTM028 stent group than in the TURP group (p<0.05, Table 1). And the mean operating time and hospital day were significantly shorter in the MemokathTM028 stent group than in the TURP group (p<0.05, Table 1). There was significant difference in the post-operative IPSS (irritation symptom) and voiding volume between MemokathTM028 stent insertion group and TURP group (p=0.026 and 0.016, respectively). In comparison with preoperative and postoperative parameter, IPSS (obstructive symptom), Qmax, and PVR significantly improved in the MemokathTM028 stent group during postoperative 1 year (p<0.05). However, there was significant difference in the IPSS (obstructive symptom), Qmax, and PVR between postoperative 1 years and 2 years (p<0.05). The postoperative complication rate was 33.3% in the MemokathTM028 stent group; pain (6/30), incontinence (2/30), and migration (2/30).

There were significantly no difference on the mean age and mean prostate volume in the MemokathTM028 stent insertion and TURP group. However, ASA scores, operation times, and hospital stay were significantly different between the MemokathTM028 stent group and the TURP group. All patients who underwent intra-prostatic stent insertion had irritation symptoms during follow-up periods. However, obstruction symptoms in all patients who underwent stent insertion and TURP were improved compared preoperative with postoperative parameters. Although minimal complications (33.3%) existed, the removal of stent was not carried out.

We suggested that the thermo-expandable intra-prostatic stent (MemokathTM028) may be an alternative procedure for BPH with significant comorbidities, despite the effect of intra-prostatic stent decreased after postoperative 2 years.