Dr. Elterman on the evolution of prostatic stents for BPH

In this video, Dean S. Elterman, MD, MSc, FRCSC, provides an overview of the publication, “A scoping review of office-based prostatic stents: past, present, and future of true minimally invasive treatment of benign prostatic hyperplasia,” for which he served as the senior author. Elterman is a urologist at University Urology Associates and a faculty member in the University of Toronto's division of urology in Ontario, Canada.

Video Transcript:

We had the idea of doing a scoping review of office-based BPH stents, as this is really becoming a new and evolving hot topic in the area of male functional urology. It's an interesting story, because there's been an evolution of stents from the late 1990s, things like the UroLume and Memokath, and then they fell out of favor. Now, we've had almost a renaissance of these new, what I've called stent 2.0s. Some of them are now already on the market. There's a whole plethora of them under final phase investigations, and they're going to be coming to the market. Now seems to be the perfect time to do this scoping review and see what is out there and what is coming out.

In this review, we were able to identify in the literature the currently available stents. We didn't spend too much time on the historical ones only because they're really not used in the marketplace, but we did, of course, mention their utilization. The real issue with the older stents, which is evidenced in the literature review, is that they were successful in improving symptoms, but they had high levels and rates of complications, such as migration, encrustation, or just pain or dysuria. As I said, they really fell out of favor. Now with a change in the materials, so the new stents are using nitinol, they're using much less material, so it's much less likely to become encrusted. The design is such in that they're less likely to migrate or move.

We were able to identify in the literature review the currently available stents. We have the iTind, which stands for temporary implantable nitinol device. That is a temporary stent which is placed in the prosthetic urethra for 5 to 7 days. It causes ischemic necrosis and essentially an opening up of the prostate and then it's removed. That's the Olympus stent iTind. There's another stent available in some parts of the world called the Allium, a BPH stent. That's also a coated nitinol stent. Then we reviewed essentially the literature in terms of the outcomes for those currently available stents.

Then also, there's a whole new group of stents coming out such as the Zenflow Spring System, the Prodeon-Expander, the Butterfly, the Rivermark FloStent, the ProVerum ProVee, and they're also under investigation right now. They're in phase 3 studies, and they will soon be on the market as well. So, we looked at what was currently published to see their early outcomes.

This transcription has been edited for clarity.