A BIOABSORBABLE SELF-EXPANDABLE, SELF-REINFORCED POLY-L-LACTIC ACID URETHRAL STENT FOR RECURRENT URETHRAL STRICTURES - A PRELIMINARY-REPORT

Purpose: We studied whether a new bioabsorbable self-expandable, self- retaining and self-reinforced poly-l-lactic acid double spiral stent i s able to prevent the edges of a cut recurrent urethral stricture from adhering together and the scar from shrinking, thus obviating strictu re recurrence. Materials and Methods: A bioabsorbable spiral stent was inserted into the stricture site in the urethra immediately after opt ical urethrotomy in 22 patients with recurrent urethral stricture. Uro flowmetry, measurement of residual urine volume, urine culture and ure throscopy were performed before and 1, 3, 6 and 12 months after optica l urethrotomy. Results: All 22 patients voided freely on day 1 or 2 af ter urethrotomy. The stent slipped partially proximal to the stricture and had to be changed in only 1 patient. The stent was totally epithe lialized in all but 1 patient at 6 months and had degraded in all at 1 2 months. The improvement in flow rate was maintained during followup except in 10 patients with stricture recurrence, which was outside the stent area usually close to the external sphincter in 7 and in the st ent area in 3. All recurrences were treated with repeat optical urethr otomy and a new stent was inserted. Urinary infections developed in 2 patients and were successfully treated with oral antibiotics. Conclusi ons: The self-expandable self-reinforced poly-l-lactic acid double spi ral stent is a promising new method in the treatment of recurrent uret hral strictures. There is no need to remove the device and no foreign material remains in the urethra. However, longer followup and controll ed studies are needed to evaluate all benefits and side effects of thi s new treatment modality.