Treatment of recurrent posterior and bulbar urethral strictures with expandable metallic stents.

PURPOSE

The role of expandable metallic Z stents (non-mesh) in the treatment of recurrent posterior and bulbar urethral strictures was evaluated.

PATIENTS AND METHODS

Seven men with recurrent posterior/bulbar urethral strictures underwent balloon angioplasty followed by insertion of two stents in tandem. Retrograde urethrography, micturating cystourethrography, and urodynamic evaluation of these patients was done initially.

RESULTS

Successful dilation and placement of stents was possible in all cases. In one patient slight proximal migration of the stent occurred; terminal dysuria in this patient necessitated stent extraction. In two other patients near total occlusion of the stent by an exuberant fibrous reaction occurred and this open urethroplasty in the other. Immediate postprocedure urethrography and urodynamic evaluation showed significant improvement. Five patients continue to show a satisfactory clinical urodynamic response. The follow-up period in this patient group ranged from 5 months to 1 year.

CONCLUSION

Short-term response (5 months to 1 year) in patients with posterior/bulbar urethral strictures treated with Z stents appears promising. However, the efficacy of the procedure on a long-term basis requires further follow-up and evaluation.