A New Treatment Option for Benign Prostatic Hyperplasia

Recently, the Department of Urology at Taikang Xianlin Gulou Hospital, Affiliated to Nanjing University Medical School, successfully performed a urethral memory metal prostate stent implantation for 97-year-old Mr. Sun, a resident of Taikang Zhijia Huiyuan with severe benign prostatic hyperplasia complicated by urinary retention. Right after the surgery, Mr. Sun regained spontaneous urination and no longer needed an indwelling urinary catheter.

This successful medical-elderly care integrated case marks a technical breakthrough in minimally invasive treatment for complex, advanced-age and high-risk urological diseases at our hospital, offering a more humanized therapy choice for elderly patients.

Since the start of this year, our hospital has launched online remote clinics to deliver multi-disciplinary (MDT) integrated medical-elderly care services for surrounding Taikang Zhijia communities. Mr. Sun, who received the prostate stent implantation, benefited from the hospital’s online consultation program for retirement communities. The hospital has built an expert pool of 85 specialists covering gastroenterology, urology, dermatology, otolaryngology, ophthalmology, TCM rheumatology and other disciplines that treat common geriatric illnesses, enabling seniors to access top-tier specialists from a Grade A tertiary general hospital without leaving the community.

One month prior, Mr. Sun suffered recurrent urinary retention due to severe prostate hyperplasia, enduring painful voiding difficulties and long-term catheterization. At nearly 100 years old, his prostate was enlarged to about 137ml, equivalent to 2 to 3 eggs. Multiple hospitals deemed traditional transurethral prostate resection too risky and recommended permanent suprapubic cystostomy.

However, Mr. Sun and his family were deeply concerned about lifelong catheterization. Recommended by the lifestyle manager at Taikang Zhijia Huiyuan, they learned that Professor Ge Jingping, Director of the Urology Department at Taikang Xianlin Gulou Hospital, and his team provide various minimally invasive prostate treatments. With support from the hospital’s integrated medical-elderly care working group and outpatient department, Mr. Sun completed an initial video consultation with Director Ge via the remote medical-elderly care platform.

"Many elderly patients unfit for conventional prostate surgery think urinary retention can only be managed with permanent catheters, yet minimally invasive procedures can completely resolve their troubles," stressed Professor Ge Jingping, Director of Urology. "Combining precise assessment with technical innovation lets seniors age with dignity, which is no longer an empty promise. This case brings the full advantages of Taikang medical resources to elderly residents of Huiyuan Community."

Faced with the ultra-advanced age and high surgical risks, the Urology team immediately held a multidisciplinary consultation. Taking Mr. Sun’s cardiopulmonary function, prostate anatomical features and personal demands into full consideration, the team finalized the advanced minimally invasive procedure: thermal-expansion memory metal urethral prostate stent implantation.

The operation was performed under local anesthesia with cooperation from the Anesthesiology & Surgery Center. Through the natural urinary tract, Professor Ge Jingping’s team implanted a thermal-expansion nitinol memory alloy stent to rapidly relieve urethral obstruction. The stent implantation requires no surgical incision, avoiding general anesthesia and complications like bleeding or infection linked to traditional surgeries, drastically lowering treatment risks. The whole procedure took only 20 minutes. Right after surgery, Mr. Sun could urinate independently, saying excitedly: "I can finally take out the catheter and pee normally!"

Benign prostatic hyperplasia is prevalent among elderly men, triggering voiding dysfunction, recurrent urinary retention, urinary tract infections, hematuria, bladder stones, hydronephrosis and even life-threatening conditions. In the past, suprapubic cystostomy was the sole solution for patients ineligible for invasive surgery, yet long-term catheterization severely impairs quality of life.

The thermal-expansion nitinol memory alloy prostate stent technology introduced by our Urology Department delivers a new therapeutic option for BPH patients who cannot tolerate basic anesthesia or standard surgery and refuse permanent catheterization.

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