Presented by: Keng Ng BSc(Med), MBBS, MS, FRCS(Urol) , PhD
Frimley Health NHS Foundatiuon Trust

Introduction

Urinary retention is a common presenting issue to urologists. Conventional per urethral catheters have often been the main stay of treatment for the acute setting and also in men with chronic retention. Lately a novel new temporary prostatic stent has been utilised to treat urinary retention, allowing the patient to pass urine spontaneously without need of catheters and its associated catheter related complications (blockages, UTI, bladder spasms). We present our single centre experience for Exime stent in men with both acute and chronic retention.

Materials

Retrospective data was collected for men who had Exime stent inserted form 2021-2022 in one single institution. These were men who had acute retention, chronic retention and also a cohort of men post rezum surgery who had Exime instead of the usual catheter. Exime stnets were placed under aseptic technique with installation of local anaesthetic urethral gel with ease. Baseline clnical parameters, efficacy, safety, complications  and tolerability were collected post insertion. 

Results

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30 male patients (mean age of 77.4 years) with benign prostatic enlargement as cause of their retention were included over 1 year period. 7 patients had Exime stent post Rezum surgery while 23 had acute or chronic urinary retention. 22 patients had successful outcomes with Exime stent (voided spontaneously with no  significant post void residuals) and remain catheter free. 8 patients had early complications - 5 patients were from post Rezum arm (urinary retention), while 2 patients had blockages due to debris and 1 patinet had urinary incontinence. These patients had stent  removal  and replacement with urinary catheters. the patient s with successful exime outcomes describe no pain or LUTS while maintaining spontaneous voluntary micturition. there were no reports of UTI in these men while the stent were in situ. A cohort of men with chronic retention were delighted to have regular 12 weeks Exime stent changes as their preferred choice over urinary catheters.

Conclusion

Exime stent is a safe and easy procedure to relieve urinary retention in men performed under local anaesthesia. It avoids the discomfort and complications of urinary catheters placed per urethrally and allows the patient to pass urine naturally and be catheter free. Further long term data will need to be collected to further evaluate the efficacy and cost effectiveness of Exime over urinary catheters.

Funding

None

Lead Authors

Jirayr Ajzajian, MD
Frimley Health NHS Foundation Trust

Neil Barber, MD, FRCS
Frimley Health NHS Foundation Trust