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


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).


CONCLUSIONS
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.
Choi
Eugene K
EK
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Poongnap-2 Dong, Songpa-Gu, 138-736 Seoul, Korea.
Song
Ho-Young
HY
Shin
Ji Hoon
JH
Lim
Jin-Oh
JO
Park
Hyungkeun
H
Kim
Choung-Soo
CS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000497:Alloys; D020878:Device Removal; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000379:methods*; D011859:Radiography; D055502:Secondary Prevention; D015607:Stents; D016896:Treatment Outcome; D014525:Urethral Stricture / Q000000981:diagnostic imaging* / Q000517:prevention & control*
D000497:Alloys; C013616:nitinol