Self-expanding stent insertion for urethral strictures: a 10-year follow-up

Authors


Dr G.E.P.M. van Venrooij, Department of Urology (G05.201), University Medical Centre Utrecht, PO Box 85500, 3508 GA Utrecht, the Netherlands. e-mail: G.Venrooy@chir.azu.nl

Abstract

OBJECTIVE

To evaluate the safety and efficacy of the Urolume??? endourethral self-expandable metallic stent (American Medical Systems, MI, USA) in treating urethral strictures, based on a follow-up of> 10 years.

PATIENTS AND METHODS

Between November 1989 and June 1990, the Urolume stent was inserted into 15 patients (aged 25–77 years) who had recurrent urethral strictures. The mean duration of stricture before stent insertion was 10.9 years. The patients (all men) were followed using a questionnaire and uroflowmetry, and if necessary, retrograde cysto-urethrography and/or urethroscopy and/or X-ray urodynamics.

RESULTS

Two failures were caused by excessive tissue proliferation in the stent, which ended in stent removal or a suprapubic catheter. Another two stents were removed because of discomfort or pain. Two patients developed stenosis in the stent after 7 and 9 years. In the final evaluation only two of the 15 patients were satisfied with their stent. The mean maximum urinary flow rate at the last follow-up was 15 mL/s, and half the patients noted ‘stent’ incontinence. Lower urinary tract infections, urge and stress incontinence, and discomfort with ejaculation, were all symptoms perceived at the last follow-up.

CONCLUSION

The long-term results of the Urolume stent in this study weaken the optimistic early results. Only two of the 15 patients were satisfied with their stent.

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