A prospective, randomized trial evaluating the use of hydrogel coated latex versus all silicone urethral catheters after urethral reconstructive surgery.

Abstract

The superiority of silicone over latex based catheters following urethral reconstructive surgery for stricture disease has been theorized, and yet data comparing their use in this group of patients are lacking. We present our findings from a prospective, randomized trial comparing silicone to hydrogel coated latex catheters in patients following urethral reconstructive surgery. From February 2004 to August 2006 men undergoing urethral reconstructive surgeries were randomized to receive an all-silicone or a hydrogel coated latex urethral catheter for postoperative bladder drainage. Patient demographics and the various reconstructive procedures used were analyzed. Complications and stricture recurrence were evaluated in the 2 groups. A total of 85 men were randomized to receive a silicone (43) or a latex (42) catheter following reconstructive surgery. Median followup was 20 months (range 10 to 36). Mean patient age, urethral stricture length, complication rate and type of reconstructive procedure did not significantly differ between the 2 groups. Five patients (11%) per group required repeat instrumentation for stricture recurrence (p = 0.97). Median time to stricture recurrence was not statistically different between the 2 groups. The theoretical benefit of silicone catheters over hydrogel coated latex catheters does not appear to translate into a clinical advantage after urethral reconstructive surgery since we found no difference in the rate of recurrence or operative complications at intermediate term followup. It appears that the 2 types of catheter are appropriate for urethral stenting following urethral reconstructive surgery.