Outcomes of the EXIME prostatic stent: A prospective feasibility study in black South African patients

Purpose Urinary retention due to Benign Prostatic Hyperplasia (BPH) is a frequent and serious urological emergency. This study evaluated the feasibility, efficacy, and clinical outcomes of the EXIME temporary prostatic stent as an alternative to traditional catheterisation. Methods A prospective study including 50 male patients presenting with BPH-related urinary retention or those awaiting definitive surgery was performed. The EXIME stent was inserted as an outpatient for a one-month indwelling period. Primary endpoints included voiding efficacy and ease of use. Secondary outcomes assessed sexual function restoration, pain and bacterial colonisation rates. Results Spontaneous voiding was achieved in all 50 patients with a mean maximum flow rate (Qmax) of 18.01 ml/s, 95% CI [16.3, 19.6] and a mean post-void residual (PVR) of 22.6 ml, 95% CI [18.2, 27]. A significant restoration of sexual function was observed with 88% of previously sexually active men regaining function (p < 0.001). Bacterial colonisation rates improved, with dipstick nitrite positivity dropping from 26% pre-insertion to 0% at removal (p < 0.001). Procedurally, 90% of insertions were graded as extremely easy to easy (VAS 1–3) and 84% of patients reported only minimal to uncomfortable pain (VAS 1–3). The failure rate was 4% with only two early removals documented. Conclusion This study represents the first clinical experience on this novel technique on the continent of Africa, demonstrating a safe, effective, and well-tolerated alternative to traditional catheterization by providing immediate symptom relief and improved outcomes regarding sexual function and bacterial colonisation, thus supporting its use in the management of BPH-related urinary retention.