ダブルマコレット型尿道留置ステントの使用経験 : 特に合併症について

Abstract

1)合併症のため手術適応のない前立腺肥大症患者5例に対し, 計7回ダブルマレコット型尿道ステントを留置した。2)排尿障害は, ノモグラムPFRにて3例で改善, 1例で不変, 1例で悪化を示した。3)合併症としては交換時に2例で膀胱タンポナーデを, 1例に尿意切迫, 頻尿を, 1例にステント内への砂状結石の付着を認めた。4)retrospectiveな検討にて, proximal basketを前立腺部尿道に固定することが合併症の軽減に重要であると考えられた

Double Malecot type polyurethane intraurethral stent (IUS) was used on 5 patients with benign prostatic hypertrophy (once in 3 patients and twice in 2 patients). They were unfit for operation because of emphysema in 3 cases, asthma and heart disease in one case. IUS with an effective length 35, 40 or 45 mm was selected according to the length of the prostatic urethra and was inserted under fluoroscopic guidance. IUS was successfully placed at the first trials in all patients, but the stent could not be changed in two patients because of bladder tamponade. Peak flow rate (PFR) was improved in 3 cases, unchanged in 1 and worse in 1. The complications were bladder tamponade in 2 cases, urgency and frequency in 1 and encrustation in 1. These findings suggested that positioning the proximal basket of the stent at the prostatic urethra near the bladder neck is important.