A randomised study to evaluate the efficacy of a biodegradable stent in the prevention of postoperative urinary retention after interstitial laser coagulation of the prostate

Objective: Interstitial laser coagulation (ILC) of the prostate induces nec rosis, oederna and increased risk for postoperative urinary retention. The present randomized study was carried out to investigate the feasibility and efficacy of a biodegradable self-reinforced polyglycoic acid (SR-PGA) sten t in preventing postoperative urinary retention and the need for prolonged catheterization after ILC treatment. Material and methods: 35 males with be nign prostatic enlargement (BPE) entered the study: 21 in the ILC + stent g roup and 14 in the ILC group without a stent. A suprapubic catheter was ins erted for all patients and ILC was performed. The SR-PGA stent was inserted immediately after laser therapy in the stent group and kept open until the next morning when it was closed and the patient started trying to void. Th e suprapubic catheter was removed after voiding had started and the urinary bladder emptied adequately. Results: In the ILC + stent group voiding star ted on the first postoperative day in 17 patients and on the second day in 2 patients. Voiding was delayed in 2 cases: in 1 case due to inadequate len gth of the stent and in the other as a result of the stent placement being tao proximal. There was 1 case of urinary retention due to early degradatio n of the stent. In the ILC-only group voiding started on average 6.1 days p ostoperatively. At 1 month follow-up, the mean peak urinary flow rate had i ncreased significantly in the ILC + stent group (p < 0.05) but not in the I LC-only group (p = 0.26). Improvements in symptom scores were significant i n both groups (p < 0.005) but in terms of the mean peak urinary flow rates at 6 months follow up the improvement was significant only in the stent gro up (p < 0.05). Conclusions: The use of a SR-PGA stent enabled early voiding and is safe and effective in the treatment of postoperative urinary retent ion after ILC. The 3-4 week degradation time of the SR-PGA stent was too sh ort for some patients. There is still a need for further development work t o improve the stents and larger controlled studies to show the true value o f biodegradable stents in the treatment of BPE.