Experience with the Spanner Prostatic Stent in Patients Unfit for Surgery: An Observational Study

Grimsley, Samuel J.S.; Khan, Mohammed; Lennox, Elspeth; Paterson, Peter

doi:10.1089/end.2006.0254

Cited by 17 publications

(14 citation statements)

References 6 publications

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“…In Australia, prostate cancer is the most commonly diagnosed cancer behind skin cancer, and is the second highest cause of cancer-related deaths behind lung cancer [4]. External beam radiation therapy (EBRT) is a major clinical treatment for prostate cancer which has proven to be efficient for tumor control [5]. EBRT uses high energy x-ray beams combined from multiple directions to deposit energy (dose) within the patient tumor region (the prostate) to destroy the cancer cells.…”

Section: Introductionmentioning

confidence: 99%

Multi-Atlas-Based Segmentation of Pelvic Structures from CT Scans for Planning in Prostate Cancer Radiotherapy

Acosta

Dowling

Dréan

et al. 2013

Abdomen and Thoracic Imaging

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In prostate cancer radiotherapy, the accurate identification of the prostate and organs at risk in planning computer tomography (CT) images is an important part of the therapy planning and optimization. Manually contouring these organs can be a time consuming process and subject to intra-and inter-expert variability. Automatic identification of organ boundaries from these images is challenging due to the poor soft tissue contrast. Atlas-based approaches may provide a priori structural information by propagating manual expert delineations to a new individual space; however the inter-individual variability and registration errors may lead to biased results. Multiatlas approaches can partly overcome some of these difficulties by selecting the most similar atlases among a large data base but the definition of similarity measure between the available atlases and the query individual has still to be addressed. The purpose of this chapter is to explain atlas-based segmentation approaches and the evaluation of different atlas-based strategies to simultaneously segment prostate, bladder and rectum from CT images. A comparison between single and multiple atlases is performed. Experiments on atlas ranking, selection strategies and fusion decision rules are carried out to illustrate the presented methodology. Propagation of labels using two registration strategies are applied and the results of the comparison with manual delineations are reported.

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Section: Introductionmentioning

confidence: 99%

Multi-Atlas-Based Segmentation of Pelvic Structures from CT Scans for Planning in Prostate Cancer Radiotherapy

Acosta

Dowling

Dréan

et al. 2013

Abdomen and Thoracic Imaging

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“…Results of an observational study by Grimsley et al25 involving patients who were unfit for surgical intervention indicate that unsatisfactory outcomes are more common in patients treated with Spanner stents then previously reported. In their series of 43 patients treated with the Spanner stent, 63% had to discontinue use of the device due to immediate or delayed urinary retention or unbearable symptoms (nocturia, dysuria, severe frequency, or incontinence).…”

Section: Spanner Stentmentioning

confidence: 90%

Critical appraisal of the Spanner™ prostatic stent in the treatment of prostatic obstruction

McKenzie¹,

Badlani²

2011

MDER

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The Spanner™ stent was first used in patients to relieve bladder outlet obstruction (BOO), and has recently been used in patients following transurethral microwave thermotherapy and men unfit for surgical intervention. We review the current literature on the role of the Spanner stent in treating prostatic obstruction compared to previously reported cases involving the use of temporary stents. The Spanner stent has been found to be successful in treating patients with bladder outlet obstruction from benign prostatic hyperplasia and following high-energy transurethral microwave thermotherapy (TUMT). Patients with the Spanner stent had an increase in peak flow rate and a decrease in post void residual and International Prostate Symptom Scores. In patients treated with TUMT, quality of life measures indicate that the Spanner stent shows increased ease of bladder drainage, decreased leakage, and no adverse effect on daily activities. In patients unfit for surgery, however, there was increased retention and pain requiring stent removal in 63% of cases. The Spanner stent offers ease of insertion with a decrease in voiding symptoms in selected patients. Based on limited data, the Spanner stent has been recommended as a treatment option for men with BOO following TUMT. However, it is not a good treatment option for men unfit for surgery based on an increased incidence of urinary retention and dysuria. The Spanner stent is the only currently approved temporary stent and, based on a literature review, it does not offer significant advantage over previously used temporary stents. It is notable that most researchers have not evaluated the role of detrusor function on the outcomes.

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“…In the series by Grimsley et al [24], 43 consecutive patients who were unfit for surgery were treated with the Spanner between March 2004 and November 2005. If tolerated, the stents were replaced every three months.…”

Section: Discussionmentioning

confidence: 99%

First Experiences with the Spanner™ Temporary Prostatic Stent for Prostatic Urethral Obstruction

Goh

Kastner²,

Khan³

et al. 2013

Urol Int

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Objectives: To assess the ease of insertion and removal of a temporary prostatic stent (the Spanner™) following the use of a prostatic urethral measuring device (the Surveyor™). Patients and Methods: Patients with bladder outflow obstruction or urinary retention awaiting definitive surgery were fully consented. Data were collected pre- and post-insertion and patients followed-up until definitively treated. Results: 16 patients had the Spanner inserted following use of the Surveyor. All insertions were uncomplicated. 14 patients were able to void satisfactorily immediately post-insertion with a mean Q_max of 15.0 ml/s and post-void residual of 51.3 ml. No symptomatic infection was reported. The stents stayed in situ for a median of 10 days. 12 stents were removed prematurely due to severe symptoms or retention. A total of 12 stents had to be removed endoscopically. Conclusions: The Spanner is easy to insert. Stent removal via the retrieval suture has been difficult necessitating the use of endoscopy in the majority of cases. Possible causes of stent failure include underestimation of the prostatic urethral length by the Surveyor leading to obstruction by apical prostatic tissue, excessive suture length between the stent and distal anchor permitting proximal migration or inadequate suture length leading to urinary incontinence. Further design modifications are suggested.

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Experience with the Spanner Prostatic Stent in Patients Unfit for Surgery: An Observational Study

Cited by 17 publications

References 6 publications

Multi-Atlas-Based Segmentation of Pelvic Structures from CT Scans for Planning in Prostate Cancer Radiotherapy

Multi-Atlas-Based Segmentation of Pelvic Structures from CT Scans for Planning in Prostate Cancer Radiotherapy

Critical appraisal of the Spanner™ prostatic stent in the treatment of prostatic obstruction

First Experiences with the Spanner™ Temporary Prostatic Stent for Prostatic Urethral Obstruction

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Experience with the Spanner Prostatic Stent in Patients Unfit for Surgery: An Observational Study

Cited by 17 publications

References 6 publications

Multi-Atlas-Based Segmentation of Pelvic Structures from CT Scans for Planning in Prostate Cancer Radiotherapy

Multi-Atlas-Based Segmentation of Pelvic Structures from CT Scans for Planning in Prostate Cancer Radiotherapy

Critical appraisal of the Spanner&trade; prostatic stent in the treatment of prostatic obstruction

First Experiences with the Spanner™ Temporary Prostatic Stent for Prostatic Urethral Obstruction

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Product

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Critical appraisal of the Spanner™ prostatic stent in the treatment of prostatic obstruction