Prospective Urethral Stent Trial For

1. No. 063 Prospective Urethral Stent Trial For Stabilisation Of Recurrent Bulbar Stricture – A Preliminary Report Eddy Wong, James Wong, Vincent Tse Royal Prince Alfred Hospital and Concord Hospital, Sydney • Introduction • Urethral strictures are commonly managed initially by endoscopic urethrotomy or dilatation • Various methods have been employed to keep the stricture stabilised after initial treatment including intermittent self-catheterization or leaving a catheter temporarily • Despite this there is a high re-stricture rate as reported in the literature requiring further endoscopic or reconstructive surgery1,2 • We hypothesize this is due to a lack of scaffolding to stabilise the stricture site during the process of healing and re-epithelisation after endoscopic treatment • Results • To date 30/40 patients have been recruited in this ongoing trial • Patient demographics (median/range) • 18/30 patients have had 6 months of followup and 9/30 have had 12 months of followup • Preliminary results shows significant improvements in Qmax which is sustained out to 12 months as shown : • 3/30 recruited patients had early failures with re-stricture post stent removal and subsequently underwent • formal urethroplasty (n=1) • permanent stent insertion (n=2) • There were no significant complications such as stent migration, encrustation or urosepsis during the study period Aim The aim of the study is to examine whether short term (3 month) deployment of urethral (Memokath™) stent in conjunction with endoscopic treatment of recurrent bulbar urethral strictures results in sustained stabilisation of the stricture site. • Methods • A prospective study is conducted recruiting 40 patients with recurrent bulbar urethral strictures • A urethral stent is deployed and left in situ for 3 months following endoscopic dilatation or urethrotomy • Re-stricture rates are prospectively collected by examining the peak flow rates • before stent deployment • 3, 6 and 12 months post stent removal • Urethroscopy is performed at 1 year • This study has been granted ethics approval by Sydney South West area health service • Conclusions • Preliminary results suggest that re-stricture rates are low after short term deployement of urethral stent in conjunction with endoscopic management of recurrent urethral strictures • Further studies with longer followup is required References Heyns CF, Steenkamp JW, De Kock ML et al: Treatment of male urethral strictures: is repeated dilation or internal urethrotomy useful? J Urol 1998; 160: 356. Role of Direct Vision Internal Urethrotomy in the Management of Urethral Stricture AUA update series 2010 Acknowledgements Dr. Andre Lalak, Dr. Lawrie Hayden, Dr. Lewis Chan, Dr. Ian Middleton, Dr. Paul Gassner, Dr. Wesley Hii, Dr. Dinesh Patel, Dr. Thomas Dean, Endotherapeutics Pty Ltd Poster presentation sponsor