title: Transurethral resection of fibrotic scar tissue combined with temporary urethral stent placement for patients with in anterior urethral stricture.
abstract: BACKGROUND
  Fibrotic scar formation is a main cause of recurrent urethral stricture after initial management with direct vision internal urethrotomy (DVIU). In the present study, we devised a new technique of combined the transurethral resection of fibrotic scar tissue and temporary urethral stenting, using a thermo-expandable urethral stent (Memokath(TM) 044TW) in patients with anterior urethral stricture.
  
  
  METHODS
  As a first step, multiple incisions were made around stricture site with cold-utting knife and Collins knife electrode to release a stricture band. Fibrotic tissue was then resected with a 13Fr pediatric resectoscope before deployment of a MemokathTM 044TW stent (40 - 60mm) on a pre-mounted sheath using 0° cystoscopy. Stents were removed within12 months after initial placement.
  
  
  RESULTS
  We performed this technique on 11 consecutive patients with initial (n = 4) and recurrent (n = 7) anterior urethral stricture (April 2009 – February 2013). At 18.9 months of mean follow-up (12-34 months), mean Qmax (7.8±3.9ml/sec vs 16.8 ± 4.8ml/sec, p < 0.001), IPSS (20.7 vs 12.5, p = 0.001 ), and QoL score (4.7 vs 2.2, p < 0.001) were significantly improved. There were no significant procedure-related complications except two cases of tissue ingrowth at the edge of stent, which were amenable by transurethral resection. In 7 patients, an average 1.4 times (1-5 times) of palliative urethral dilatation was carried out and no patients underwent open surgical urethroplasty during the follow-up period.
  
  
  CONCLUSIONS
  Combined transurethral resection and temporary urethral stenting is a effective therapeutic option for anterior urethral stricture. Further investigations to determine the long-term effects, and safety profile of this new technique are warranted.
authors.affiliation: Department of Urology and Center of Regenerative Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Cheol Yong
authors.initials: CY
authors.lastname: Yoon
authors.affiliation: Department of Urology and Center of Regenerative Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Ji Yun
authors.initials: JY
authors.lastname: Chae
authors.affiliation: Department of Urology and Center of Regenerative Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Jong Wook
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Urology and Center of Regenerative Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Urology and Center of Regenerative Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Mi Mi
authors.initials: MM
authors.lastname: Oh
authors.affiliation: Department of Urology and Center of Regenerative Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Hong Seok
authors.initials: HS
authors.lastname: Park
authors.affiliation: Department of Urology and Center of Regenerative Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Du Geon
authors.initials: du G
authors.lastname: Moon
authors.affiliation: Department of Urology and Center of Regenerative Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Jun
authors.initials: J
authors.lastname: Cheon
authors.affiliation: Department of Urology and Center of Regenerative Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Jeong Gu
authors.initials: JG
authors.lastname: Lee
authors.affiliation: Department of Urology and Center of Regenerative Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Jae Jong
authors.initials: JJ
authors.lastname: Kim
mesh_terms: D002921:Cicatrix / Q000601:surgery; D003558:Cystoscopy / Q000379:methods*; D006801:Humans; D015203:Reproducibility of Results; D015607:Stents; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery; D014525:Urethral Stricture / Q000601:surgery*