Dear Dr. Motola,** I am 62 years old. I have had Benign Prostatic Hyperplasia for about 6 years. My latest PSA count is 0.9 and I have been on Flomax for the past 6 years. My urologist prescribed Avodart which I found prevented me from having a sexual climax so have stopped taking it. He has now suggested that he “implant” a Memokath Stent to handle the urethral stricture (my urine flow is very weak and very frequent). What does the procedure involve? What the risks are? What is the success rate? How long does the “implant” last for?**
The Memokath stent is a urethral device that is intended to bridge the prostatic portion of the urethra. It is made of a nickel-titanium alloy that has “shape-memory” - the ability to be restored to its original shape when heated. It holds open the urethra by exerting a gentle outward force on the wall of the urethra. When in place, urine passes freely through the urethra into the bladder. A review in the 2006 BJU Int was inconclusive with regards to long-term success rates. The Memokath stent is a device that is manufactured in Denmark and not widely available in the U.S.
The Urolume stent however, is readily available in the U.S. and allows for the ingrowth of tissue, which over a long term may cause urethral narrowing and possibly the need for stent removal. It is the only FDA approved permanent stent for the treatment of bladder obstruction.
Due to the ease of placement of these devices, possibly with only local anesthesia and the use of a flexible cystoscope, they are best intended for patients who are poor candidates for standard treatments due to other co-existing diseases. The migration of these stents is the major reason that they are note widely used for the treatment of prostatic obstruction.
In this era of multiple minimally invasive treatments that are highly successful, and given your relatively young age, I would consult your urologist and discuss other alternatives.