Endoscopic urethroplasty with a free graft on a biodegradable XXXX spiral stent. A new technique.

@entity1 @entity39 @entity6886 @entity150 @entity158 @entity811
OBJECTIVES: Explore the possibility of an endoscopic urethroplasty with a free graft on a biodegradable, self-reinforced @entity6886 spiral stent. METHODS: Urethral strictures, failures of previous urethrotomies, which still can be incised endoscopically are selected. Strong fibrotic strictures which are bad indications for the use of a free graft are excluded. A free graft (skin on mucosa) is sutured around the stent and brought at the place of the endoscopically opened stricture where the graft is fixed with a suture through skin, bulbar muscles and spongiosum. A suprapubic diversion is left for 10 days. The stent keeps the graft in contact with surrounding well vascularized tissue where it can take. Other parts of the graft become @entity39 . The stent hydrolyses in about 3 weeks. MATERIAL AND RESULTS: 10 @entity1 with bulbar strictures from 2 to 4 cm in length and failed previous urethrotomies were treated successfully with this technique. The follow-up varies from 39 to 3 months (mean: 21 months). After 2 years 1 stricture recurred in a @entity1 who underwent regular endoscopies for recurrent @entity150 . All other @entity1 were successful until now. One stent got lost in the bladder during the procedure but could be brought at the right place. Other complications were 1 @entity811 , 1 urosepsis, 1 perineal @entity158 , 1 painful evacuation of a part of the stent 16 days after operation, and 1 difficult micturition. CONCLUSION: The preliminary experiences indicate that this technique is a possible treatment of short bulbar strictures after failure of endoscopic treatment.
