Donald J J, Rickards D, Milroy E J
Department of Radiology, Middlesex Hospital, London, England.
Radiology. 1991 Aug;180(2):447-50. doi: 10.1148/radiology.180.2.2068309.
Self-expanding metal stents are emerging as an effective alternative treatment in the management of urethral obstruction. The radiologic studies of 33 men with anterior urethral strictures (subprostatic, n = 11; bulbar, n = 22) that had recurred despite repeated optical urethrotomy and dilation were reported. In all patients, the stricture was successfully treated with stent insertion. Urethrography performed 1 month later in 19 patients showed an irregular intrastent lumen of varying degrees due to a hyperplastic urothelial reaction confirmed at endoscopy the same day. Available follow-up urethrograms in seven patients at 3 months showed that the hyperplasia was settling, and by 6 months, the intrastent lumen was smooth and of good caliber. Urethrography revealed postoperative structures in 14 patients. Strictures seen at 1 month (n = 6) were due to initial stent misplacement and were treated with the insertion of a second stent. Strictures seen 3 months after insertion (n = 4) occurred within the stent lumen and were considered to be significant at endoscopy in only one patient. Strictures that developed 6-12 months after stent insertion (n = 4) were not within the stent and were considered to represent genuine new strictures.
自膨式金属支架正逐渐成为治疗尿道梗阻的一种有效替代疗法。报告了对33例前尿道狭窄男性患者（前列腺下狭窄，n = 11；球部狭窄，n = 22）的放射学研究，这些患者尽管反复进行了光学尿道切开术和扩张，但狭窄仍复发。在所有患者中，通过置入支架成功治疗了狭窄。19例患者在1个月后进行的尿道造影显示，由于同日内镜检查证实的增生性尿路上皮反应，支架内管腔呈不同程度的不规则。7例患者在3个月时可获得的随访尿道造影显示增生正在消退，到6个月时，支架内管腔光滑且管径良好。尿道造影显示14例患者术后有狭窄。1个月时出现的狭窄（n = 6）是由于最初支架放置不当，通过置入第二个支架进行治疗。置入后3个月出现的狭窄（n = 4）发生在支架管腔内，仅1例患者在内镜检查时被认为有意义。支架置入后6 - 12个月出现的狭窄（n = 4）不在支架内，被认为是真正的新狭窄。
