Artikel
Temporary Implantable Nitinol Generation II Device (i-TIND) for treatment of LUTS: more than a bladder neck procedure?
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Veröffentlicht: | 10. Mai 2019 |
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Gliederung
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Introduction: iTIND is a minimal-invasive and fast procedure for treatment of LUTS. There are concerns regarding iTIND-treatment of LUTS patient with larger volume glands, median lobe or acute urinary retention concluding it is a bladder neck procedure (MT-01; MT-02).
Aim of the study: assessment of efficiacy of iTIND in this patient subgroup.
Methods: Prospective Analysis of Patients undergoing LUTS-treatment with iTIND not meeting criteria of MT-02 trial based on patient informed consent: large volume glands >75cc (LV-group), Patient with with median lobe and prostate <75c (ML), and patient with acute urinary retention (AUR-group). In the AUR-group, patients received cystostomy and iTIND.
Functional results (peak urinary flow, Qmax; postvoiding residual, PVR; IPSS-score) were observed.
Results: Follow-up is complete with 3 month. In the AUR-group (n=3, bladder volume: 450 ml (A), 800 ml (B), 1700 ml (C); n=2 prostate volume exceeding >75 cc: 80 cc; 95 cc) could void spontaneously with PVR, Qmax and IPSS on 3-month follow-up (60 ml, 10 ml; 32 ml/sec, 10 ml/sec; 8 Pt., 6Pt.).
1 Patient (B) could not void and continued on zystostomy until TUR-P was performed.
For 2 Patients (D,E) with median lobe and prostate <75 cc (64 cc (D), 55 cc (E); PVR: D 140 ml, E 70 ml; Qmax: D 7 ml/sec, E 8 ml/sec; IPSS: D 23, E 13) functional results improved at 3-month follow-up: PVR: 0 ml (D), 20 ml (E); Qmax: 13 ml/sec (D), 14 ml/sec (E); IPSS: 11 (D), 8(E).
Conclusions: Given our findings, it appears that iTIND is not a sole bladder neck treatment. It might be considered also in the setting of larger volume glands, median lobe or acute urinary retention.
RCT trials are mandatory in order to confirm the preliminary findings of this study and to measure the true potential of iTIND treatment and its future role in the context of BPO management.