[The permanent endourethral prosthesis (Wallstent) for the treatment of posterior urethral strictures]

We present our experience with the self-expanding urethral endoprosthesis Wallstent for the treatment of recurrent posterior urethral strictures. The stent is made of a surgical-grade stainless steel alloy wire, woven into braided mesh and shaped to a tubular form. It was originally developed for use in endovascular stenoses. Immediately before implantation of the stent an internal urethrotomy with subsequent urethral dilatation is done. So far, 23 patients have been treated by this new technique of therapy, with follow-up periods of up to 25 months (mean 16.8 months). The endoprosthesis has been tolerated very well by all patients. Successful treatment of the strictures is confirmed by the physiological uroflow obtained and the absence of residual urine after emptying of the bladder. We have seen no recurrences of stricture. After 6 months, urethroscopic control examination demonstrates complete epithelialization of the urethral stent. One year after implantation the endoprosthesis is completely incorporated. The original diameter of 21.5 Charr is maintained, which allows subsequent transurethral endoscopic manipulation if necessary. Our encouraging results so far give reason to hope that this is a simple, safe and recurrence-free treatment for posterior strictures of the urethra.