Management of recurrent urethral strictures with covered retrievable expandable nitinol stents: long-term results.

Abstract

OBJECTIVE:

The purpose of this study was to evaluate the long-term clinical efficacy of temporary placement of covered retrievable stents in the management of recurrent urethral strictures.

MATERIALS AND METHODS:

During the period December 1998-December 2005, 32 men and one adolescent boy (mean age, 48.6 years; range, 16-73 years) with recurrent urethral strictures underwent fluoroscopically guided insertion of a total of 68 stents. Patients without complications underwent elective stent removal 2 or 4 months after stent insertion. Rates of clinical success (long-term clinical and radiographic resolution of urethral strictures) were assessed. The Mann-Whitney U test was used to compare the duration of stent placement in patients with long-term clinical resolution with that in patients with stricture relapse.

RESULTS:

Clinical success was achieved in 18 (55%) of the 33 patients. The mean duration of stent placement in patients with clinical success was significantly different from that in patients who had recurrences (p < 0.0001). Stricture relapse did not occur in only four (20%) of 20 cases of stent placement for 2 months. All 14 stent placements lasting at least 4 months resulted in long-term resolution after a mean follow-up period of 3.6 years. The most common complications necessitating early stent removal were stent migration (33.8% of stents) and tissue hyperplasia (20.6% of stents).

CONCLUSION:

Placement of a covered retrievable stent for a minimum of 4 months is effective in inducing long-term resolution of refractory urethral strictures. Stent migration remains the largest obstacle in achieving adequate duration of stent placement.

• Authors: Eugene K Choi, Ho-Young Song, Ji Hoon Shin, Jin-Oh Lim, Hyungkeun Park, Choung-Soo Kim
• Journal: AJR. American journal of roentgenology (AJR Am J Roentgenol) Vol. 189 Issue 6 Pg. 1517-22 (Dec 2007) ISSN: 1546-3141 [Electronic] United States
• PMID: 18029894 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Alloys
• nitinol

Topics

• Adolescent
• Adult
• Aged
• Alloys
• Device Removal
• Humans
• Longitudinal Studies
• Male
• Middle Aged
• Prosthesis Implantation (methods)
• Radiography
• Secondary Prevention
• Stents
• Treatment Outcome
• Urethral Stricture (diagnostic imaging, prevention & control)