i-TIND – Temporary Prostatic Stent

Why is this done?

  • This procedure is performed when the prostate gland is causing LUTS and you want an alternative to medication without the complications of a permanent procedure.
  • Ejaculation sparing
  • Symptoms include:
    • a weak stream,
    • nightly urination,
    • frequent urination,
    • inability to urinate,
    • kidney failure due to the obstruction,
    • bladder stones,
    • recurrent bladder infections.
  • Medication such as Flomaxtra, Urorec Minipress etc.  should always be given as a first resort.
  • Duodart should not be prescribed for a man wishing to preserve sexual function.
  • This is alternative to medication where ejaculatory function is to be preserved.
  • Prostate cancer first needs to be ruled out by doing a PSA, and when indicated, with a 3T MRI scan of the prostate with an abnormal PSA with a possible prostate biopsy of any suspicious lesions.
  • Prostate sizes up to 80-90 cc even midlobes are acceptable.

How is it done?

  • Patients will receive a general anesthesia, unless contra-indicated.
  • A cystoscopy is performed by placing a camera in the urethra with the help of a lubricant jelly and an irrigant (fluid).
  • The inside of the bladder is viewed for pathology. If any suspicious lesions are seen, a biopsy will be taken.
  • The device is placed through the cystoscopy sheath.
  • A string will be left hanging out
  • Prophylactic antibiotics will be given to prevent any infections.

 

Prophylaxis

  • Prophylactic antibiotics.
  • Cease all anti-coagulants i.e.: Warfarin and Aspirin 7-10 days prior to surgery.
  • A script for Clexane 40mg daily subcutaneously will be provided to be commenced 7 days before biopsy when you Warfarin is ceased.

What to expect afterwards

  • Any anesthesia has its risks, and the anesthetist will explain this to you.
  • You may in extreme cases experience some blood loss.
  • You will have a string hanging out from your urethra for 5-7 days
  • Don’t pull on the string
  • Lower abdominal discomfort for a few days
  • Could have an inflammatory response requiring antibiotics.
  • Discomfort in urination and frequency and urgency while the stent is in.
  • You will be needed to return a week later for another day procedure under sedation for the removal of the stent
  • A trial of void to confirm good urination
  • Allow for 6 weeks for stabilization of symptoms thereafter.
  • There may be some blood in your urine for up to 4 weeks post op. You can remedy this by drinking plenty of fluids until it clears.
  • A follow-up appointment will be scheduled for 6 weeks.
  • DON’T SUFFER IN SILENCE, OR YOU WILL SUFFER ALONE!

 

Complications

  • Hematuria (blood in urine) 2-3days.
  • Ejaculation will not be affected thus preserving sexual function
  • Infertility should not be an issue as there is no retrograde ejaculation. Don’t do it if you still want children.
  • No Stress incontinence especially in the elderly and the diabetic patients
  • May experience a slower stream initially due to swelling
  • Some urgency symptoms for 6 weeks
  • Possible infection.
  • Further enlargement of prostate lobes within 3-5 years requiring a repeat procedure.
  • NB! Each person is unique and for this reason symptoms vary!

 

ANY FEVER OR RIGORS REQUIRES URGENT ATTENTION

Download Information Sheet

Wes iTIND Therapy

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