Self-expanding stent insertion for urethral strictures: a 10-year follow-up.

OBJECTIVE: To evaluate the safety and efficacy of the Urolume endourethral self-expandable metallic stent (American Medical Systems, MI, USA) in treating urethral strictures, based on a follow-up of> 10 years.

PATIENTS AND METHODS: Between November 1989 and June 1990, the Urolume stent was inserted into 15 patients (aged 25-77 years) who had recurrent urethral strictures. The mean duration of stricture before stent insertion was 10.9 years. The patients (all men) were followed using a questionnaire and uroflowmetry, and if necessary, retrograde cysto-urethrography and/or urethroscopy and/or X-ray urodynamics.

RESULTS: Two failures were caused by excessive tissue proliferation in the stent, which ended in stent removal or a suprapubic catheter. Another two stents were removed because of discomfort or pain. Two patients developed stenosis in the stent after 7 and 9 years. In the final evaluation only two of the 15 patients were satisfied with their stent. The mean maximum urinary flow rate at the last follow-up was 15 mL/s, and half the patients noted 'stent' incontinence. Lower urinary tract infections, urge and stress incontinence, and discomfort with ejaculation, were all symptoms perceived at the last follow-up.

CONCLUSION: The long-term results of the Urolume stent in this study weaken the optimistic early results. Only two of the 15 patients were satisfied with their stent.