The long-term results of temporary urethral stent placement for the treatment of recurrent bulbar urethral stricture disease

Abstract

Aim:To evaluate the long term outcomes of temporary urethral stent placement for the treatment of recurrent bulbar urethral stricture.Materials and Methods:Twenty-eight patients who underwent temporary polymer coated urethral stent placement due to recurrent bulbar urethral stricture between 2010 and 2014 were enrolled in the study. The long term outcomes of the patients were analyzed.Results:The mean age of the patients was 62.3±6.4 (44–81). The overall clinical success was achieved in 18 (64.2%) of the 28 patients at a median (range) follow-up of 29 (7–46) months. No patient reported discomfort at the stent site. Stone formation was observed at the urethral stent implantation area only in one patient. Stenosis occurred in the distal end of the stents in two patients and took place in bulbar urethra in seven patients after removed the stents. The mean maximum urine flow rates were 6.24±2.81mL/sec and 19.12±4.31mL/sec before and at 3 months after the procedure, respectively.Conclusion:In this study, the success rate of temporary urethral stent placement has remained at 64.2% at a median follow-up of 29 months. Therefore, our outcomes have not achieved desired success rate for the standard treatment of recurrent bulbar urethral stricture.

Management of Recurrent Urethral Strictures: A Therapeutic Challenge

“…Various management modalities of urethral stricture disease, such as internal urethrotomy, intermittent urethral dilatations, and open urethroplasties, have been well described in the literature [ 2 , 3 , 7 ]. However, clear curative roles of these interventions are still underway with unimpressive rates of success.…”

“…Complex stricture could have possibly been the cause of recurrence despite an excision anastomotic urethroplasty in our patient. Studies have also clearly highlighted internal urethrotomy and urethral dilatation as a causative factor for an elevated rate of recurrent urethral strictures with a low long-term efficacy [ 2 , 7 ].…”

“…Temporary urethral stenting, however, following urethral dilation or internal urethrotomy has been found to maintain urethral patency and decrease stricture recurrence, clearly without the need for permanent implantation [ 6 ]. The literature review also suggests the use of temporary urethral stent placement for recurrent bulbar urethral strictures after direct visual internal urethrotomy or dilatation as an option before deciding on urethroplasty [ 7 ]. This comparatively enables urologists to approach the patient with a minimally invasive procedure and overall compliance with the patient's satisfaction rather than surgically reconstructing the urethra.…”

“…Temeltas et al analyze temporary urethral stent implementation, particularly in patients who have undergone numerous internal urethrotomy or dilatations [ 7 ]. This initiates a strategic plan for patients with failures from repeated urethrotomy or dilatations.…”

Initial experience with Allium™ stent in the management of bulbar urethral stricture

“…However, temporary stents may also migrate, encrust, become infected or cause irritative symptoms including dysuria and haematuria (14). …”