Biodegradable braided poly(lactic-co-glycolic acid) urethral stent combined with dutasteride in the treatment of acute urinary retention due to benign prostatic enlargement: a pilot study

Authors

  • Andres Kotsar,

    1. Department of Urology, Tampere University Hospital and Medical School, University of Tampere, Department of Biomedical Engineering, Tampere University of Technology, Tampere, and
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  • Taina Isotalo,

    1. Department of Surgery, Päijät-Häme Central Hospital, Lahti, Finland
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  • Hanne Juuti,

    1. Department of Urology, Tampere University Hospital and Medical School, University of Tampere, Department of Biomedical Engineering, Tampere University of Technology, Tampere, and
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  • Joonas Mikkonen,

    1. Department of Urology, Tampere University Hospital and Medical School, University of Tampere, Department of Biomedical Engineering, Tampere University of Technology, Tampere, and
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  • Jenni Leppiniemi,

    1. Department of Urology, Tampere University Hospital and Medical School, University of Tampere, Department of Biomedical Engineering, Tampere University of Technology, Tampere, and
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  • Venla Hänninen,

    1. Department of Urology, Tampere University Hospital and Medical School, University of Tampere, Department of Biomedical Engineering, Tampere University of Technology, Tampere, and
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  • Minna Kellomäki,

    1. Department of Urology, Tampere University Hospital and Medical School, University of Tampere, Department of Biomedical Engineering, Tampere University of Technology, Tampere, and
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  • Martti Talja,

    1. Department of Surgery, Päijät-Häme Central Hospital, Lahti, Finland
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  • Teuvo L.J. Tammela

    1. Department of Urology, Tampere University Hospital and Medical School, University of Tampere, Department of Biomedical Engineering, Tampere University of Technology, Tampere, and
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Andres Kotsar, Department of Urology, Tampere University Hospital, PO Box 2000, 33521 Tampere, Finland. e-mail: andres.kotsar@uta.fi

Abstract

OBJECTIVE

To evaluate, in a pilot study, the efficacy and safety of combining a braided poly(lactic-co-glycolic acid) (PLGA, a copolymer of l-lactide and glycolide) urethral stent and dutasteride in the treatment of acute urinary retention (AUR) due to benign prostatic enlargement (BPE).

PATIENTS AND METHODS

Ten men with AUR due to BPE were treated as outpatients. A biodegradable braided PLGA urethral stent was inserted into the prostatic urethra, using a specially designed insertion device under visual control. Dutasteride treatment was started and the patients were followed up for 3 months after insertion of the stents.

RESULTS

In all patients the stents were placed successfully with the new insertion device. All men were able to void after inserting the stent. At 1 month five patients voided freely with a low residual urine volume (<150 mL), two voided but had a high residual urine volume and a suprapubic catheter was placed, and three needed a suprapubic or an indwelling catheter before 1 month, due to AUR or comorbidities. At 3 months five patients were voiding with no problems.

CONCLUSIONS

We have developed a new and effective insertion device for biodegradable braided prostatic stents. The new braided-pattern stent overcomes the earlier problems of migration and sudden breakage into large particles associated with biodegradable spiral stents. However, the mechanical properties of the new stent need to be improved and tested in a longer follow-up. We consider that this new biodegradable braided-pattern urethral stent could provide a new option in the future treatment of AUR.

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