Recurrent traumatic urethral strictures near the external sphincter: Treatment with a covered, retrievable, expandable nitinol stent - Initial results

Ho Young Song, Hyungkeun Park, Tae Suk Suh, Gi Young Ko, Tae Hyung Kim, Eun Sang Kim, Taehan Park

Research output: Contribution to journalArticlepeer-review

37 Scopus citations

Abstract

PURPOSE: To investigate the clinical effectiveness of a covered, retrievable, expandable nitinol stent in treating traumatic urethral strictures near the external sphincter. MATERIALS AND METHODS: The stent was 10 mm in diameter when fully expanded and 40-50 mm long. To make it removable, two nylon drawstrings were attached to its lower inner margin. Twelve consecutive men (19-67 years; mean age, 47 years) with traumatic urethral strictures near the external sphincter that were refractory to endoscopic urethrotomy were treated. With fluoroscopic guidance, a stent was placed to completely bridge the external sphincter. The stent was electively removed with a retrieval hook wire 2 months after placement. Stent placement and removal were successful in all patients, with no procedural complications. RESULTS: Mean maximum urine flow rate was 5 mL/sec (range, 3-7 mL/sec) before stent placement and 27 mL/sec (range, 16-40 mL/sec) at 1 week after placement. During the mean follow-up of 20 months (range, 2-37 months) after the first stent removal, strictures recurred in eight of 12 patients. For the eight patients with recurrence, a second stent was placed and 4 months later was removed from seven of the eight patients. During the mean follow-up of 18 months (range, 4-32 months) after the second stent removal, strictures recurred in two patients, in whom a third stent was placed and then removed 4 months later, with good results. Four (33%) of 12 patients, five (62%) of eight patients, and two (100%) of two patients were successfully treated with placement of the first stent, the second stent, and the third stent, respectively. In the remaining patient, the second stent remains in place. CONCLUSION: Placement of a covered, retrievable, expandable nitinol stent seems to be effective in treating urethral strictures near the external sphincter and warrants further investigation.

Original languageEnglish (US)
Pages (from-to)433-440
Number of pages8
JournalRadiology
Volume226
Issue number2
DOIs
StatePublished - Feb 1 2003
Externally publishedYes

Keywords

  • Genitourinary system, injuries
  • Urethra, interventional procedures
  • Urethra, stenosis or obstruction

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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