Long-term catheterisation, while commonly used, is associated with considerable morbidity, including urinary tract infection, haematuria, catheter bypassing, and impairment of mobility, intimacy, and overall quality of life (QoL). The EXIME is a novel silicone-based prostatic stent designed to provide temporary bladder drainage in men with urinary retention. It is inserted under local anaesthesia in an outpatient setting, spares the external sphincter to maintain continence, and has a functional lifespan of 12 weeks, comparable to long-term catheterisation.

This study evaluated the clinical use of the EXIME stent in men with catheter-dependent urinary retention. Secondary objectives included assessment of patient comfort, mobility, continence, infection rates, and overall QoL.

Patients with indwelling urethral catheters were screened for eligibility: prostate volume <100 cc, absence of symptomatic infection, suitability for local anaesthesia, and no anticoagulation therapy. At insertion, baseline data were collected, including a catheter-related QoL questionnaire and urine culture. All patients received single-dose oral fosfomycin prophylaxis. The EXIME stent was deployed under sterile conditions using local anaesthesia, with sizing confirmed using the manufacturer’s 22Ch tool to ensure accurate placement within the prostatic urethra.

Fourteen patients were enrolled. Eight (57%) were excluded due to early physiological intolerance, defined as urinary retention or spontaneous stent expulsion within 24 hours. Six patients successfully retained the device for the study duration. Mean age was 70 years (range 63–82) and mean prostate volume 54.5 cc (range 19–81). Indications for catheter dependency included high-pressure chronic retention (n=3), acute retention with failed trials without catheter (n=2), and chronic retention with high residual volumes (n=1).

All pre-insertion urine cultures were positive (Escherichia coli or mixed growth). Following EXIME insertion, colonisation decreased to 60% at the time of stent exchange. Patients reported improved QoL compared with indwelling catheters, including reduced discomfort, improved mobility, and no incontinence. Overall, 83% reported greater comfort, alongside improved confidence and ability to resume activities including swimming and sexual intercourse.

These findings suggest that the EXIME stent is a feasible catheter-free drainage option in selected men with chronic urinary retention, with over 40% successfully maintaining the device and reporting substantial functional and quality-of-life benefits. Patients who tolerated the stent experienced restoration of continence, improved mobility, and the ability to resume normal daily and social activities, addressing key limitations associated with long-term catheter use. The observed reduction in urinary colonisation following insertion also indicates a potential role in mitigating infection burden. Early intolerance in a proportion of patients highlights the importance of careful patient selection and optimisation of insertion technique. Overall, the EXIME stent represents a promising minimally invasive alternative to indwelling catheterisation, warranting further evaluation to define its long-term efficacy, safety, and optimal clinical indications.

In patients able to tolerate the device, the EXIME stent appears a safe, minimally invasive alternative to catheterisation, with meaningful improvements in comfort, mobility, and quality of life. Further studies are required to confirm these findings in larger cohorts.