Do silver alloy-coated catheters increase risk of urethral strictures after robotic-assisted laparoscopic radical prostatectomy?

OBJECTIVES: To evaluate whether the use of silver-coated catheters increased the risk of developing urethral stricture disease after robotic-assisted laparoscopic radical prostatectomy (RALP). Recently, silver alloy-coated Foley catheters have been shown to decrease the risk of catheter-associated urinary tract infections. Other than the increased cost, no disadvantages to the use of these catheters have been reported. MATERIAL AND METHODS: We switched to routine use of the Bardex I.C. silver alloy-coated Foley catheters for all urologic procedures on November 1, 2008. After institutional review board approval, we retrospectively reviewed the records of all consecutive patients who had undergone RALP 12 months before and after the catheter change. The primary outcome was the rate of urethral strictures after RALP. RESULTS: A total of 188 RALPs were performed during the 12 months before the catheter change. No patients who underwent RALP in the months before the catheter change had developed a new postoperative urethral stricture. In the 12 months after the change to the silver-coated catheters, 217 RALPs were performed. Six patients after RALP using silver-coated catheters developed new strictures, at a rate of 2.8% (P = .03). CONCLUSIONS: Silver alloy-coated urinary catheters might increase the risk of developing urethral strictures after RALP compared with standard noncoated catheters. Additional evaluation by a large randomized prospective trial is warranted to elucidate the true risk of stricture formation.