(185) SELF-EXPANDABLE, METALLIC, PTFA-COVERED URETHRAL STENT WITH ANTI-MIGRATION FLAPS (UVENTA). COMPLICATION REPORT AND OUTCOMES FROM THE LARGEST MULTICENTER SERIES

• Published in: Journal of sexual medicine Vol. 20; no. Supplement_4
• Main Authors: Omid, Sedigh, Ettore, Dalmasso, Andrea, Gobbo, Devis, Collura, Andrea, Formiconi, Marisa, Kurti, Ernesto, Giargia, Nicola, Faraone, Paolo, Caccia, Alessandro, Giacobbe, Maria, Buffi Nicolò
• Format: Journal Article
• Language: English
• Published: 06-07-2023
• ISSN: 1743-6095; 1743-6109
• DOI: 10.1093/jsxmed/qdad062.131

Abstract
Objectives
In the last years a new generation of temporary urethral stent was designed. We report complications and outcomes from the largest case history available of self-expandable, metallic, PTFA-covered urethral stents with anti-migration flaps.
Methods
225 patients that underwent urethrotomy with Uventa stent placement between April 2016 and August 2021 in 7 different centers were included. Indication was patient preference as a first surgical approach or failed urethroplasty not willing to undergo a second invasive surgery. Surgical success was defined as absence of strictures requiring further treatments. The outcomes measured were complications during the stent indwelling time and treatment success.
Results
The stricture was located at a proximal bulbar level in 190 patients, distal bulbar in 29 and penile in 6. Median follow-up was 37.9m. 109 (48.4%) patients had at least 1 complication, the figure shows the percentage distribution. Low flow (LF) after stent placement (17, 7.6%) was reported in a significantly higher proportion in penile strictures (2/6, p=0.025). Proximal bulbar strictures had a higher number of per-patient complications (p=0.024). 23 patients (12.9%) underwent early stent removal (ER, before 6m), of these 20 stents were dislocated. ER was more likely in penile strictures (3/6, p=0.047). LF and penile strictures were predictors of ER at univariable logistic regression (p<0.001, p=0.017). Penile stricture was also predictor of LF occurrence (p=0.034). 32/150 (21.3%) experienced treatment failure. Kaplan-Meier estimates by LF occurrence were significantly different (cumulative treatment success: 80.4% vs 42.8%; p=0.011) and Cox regression HR was 3.4 (p=0.022).
Conclusions
Urethrotomy with Uventa placement is a feasible treatment for simple strictures. A detailed discussion about complications, with particular attention to stent displacement, and expectations should be carried out. LF after placement is suggestive of a subsequent ER and treatment failure. Penile strictures should not undergo urethral stent placement considering the association with ER and LF.
Conflicts of Interest
None.