iTind (Temporary Implantable Nitinol Device)

The device is made from nitinol, a nickel-titanium alloy with a shape memory: compressed into a narrow catheter for insertion, it springs back to its designed form once released at body temperature. Its structure consists of three elongated struts joined by an anchoring leaflet that sits at the bladder neck and holds the device in position, with a retrieval thread left in the urethra. When expanded, the struts exert continuous, gentle outward pressure along defined lines. Over several days that pressure produces controlled ischaemic remodelling of the tissue at those exact points, so that when the device is taken out, three incisions have effectively been created in the prostatic urethra without any cutting instrument, heat or energy. Nothing remains in the body after removal.

Placement is carried out endoscopically. Under local anaesthesia with light sedation, the urologist passes a cystoscope to confirm the anatomy and measures the length of the prostatic urethra, then advances the folded device on its delivery catheter to the bladder neck. The device is released and unfolds, and its position is checked under direct vision before the delivery system is withdrawn. The patient goes home the same day and continues normal daily activity, usually with an oral antibiotic and simple analgesia. During the next five to seven days the struts exert their steady pressure. The device is then removed in an outpatient visit: a small retrieval catheter is passed along the urethra, the device is collapsed back into it by pulling the retrieval thread and withdrawn in one movement. The whole removal takes a few minutes and needs only topical anaesthetic gel.

iTind is intended for men with moderate to severe lower urinary tract symptoms caused by benign prostatic enlargement: a weak stream, hesitancy, incomplete emptying, urgency, frequency and waking at night. It suits men who have not been helped by medication or who do not wish to take it, and who prefer to avoid a procedure that removes tissue or leaves a permanent implant. It is generally used for prostates of small to moderate size, roughly up to 75 millilitres, without a significant middle lobe protruding into the bladder. It is not suitable in the presence of prostate cancer, urinary infection, bladder stones, an underactive bladder or a urethral stricture. Assessment before treatment includes symptom scoring, flow measurement, ultrasound of the residual urine, a prostate specific antigen test and cystoscopy, and the urologist explains where iTind sits alongside other minimally invasive options such as water vapour therapy and the prostatic urethral lift.

The main benefit is a lasting change to the shape of the urinary channel with nothing left inside the body and no removal of tissue. Studies with follow-up over several years report improvement in symptom scores and flow rate, high preservation of ejaculatory function, and a low rate of retreatment in appropriately selected men. Both the placement and the removal are short, and general anaesthesia is usually avoided. During the days the device is in place, most men can carry on with ordinary activity but commonly experience urgency, frequency, burning on passing urine and sometimes blood in the urine or a feeling of pressure; this is expected and settles after removal. A few men need a catheter for a short time. After removal, symptoms typically continue to improve over the following weeks as the tissue settles into its new shape. Because the prostate continues to grow with age, further treatment may become necessary later, and no option is closed off by having had iTind.