Endourethral prostheses for urethral stricture (original) (raw)
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A novel temporary prostatic stent for the relief of prostatic urethral obstruction
BJU International, 2004
and deflates the proximal balloon when pulled. The stent was inserted under topical anaesthesia in 30 patients. The maximum flow rate (Q max), voided volume (VV), postvoid residual (PVR), the International Prostate Symptom Score (IPSS) and stent position were assessed. RESULTS Stents remained in situ for a mean (range) of 57 (1-98) days. The mean overall Q max at baseline and after insertion were 8.2 and 11.6 mL/s, representing a 42% improvement (P < 0.001); the respective mean overall VVs were similar, at 219.7 and 221.6 mL (0.9% increase, not significant) and the PVRs were 312.1 and 112.3 mL, representing a 64% decrease (P = 0.004). The overall mean IPSS declined from 22.3 before to 7.1 after insertion, representing a 68% decrease (P < 0.001). There were only minor adverse events. The stability, patency and lack of migration of the device were confirmed radiographically up to 12 weeks of use. CONCLUSIONS This early study shows that this temporary prostatic stent is easily inserted and removed, remains anchored in position, and significantly improves the Q max , PVR and IPSS while preserving volitional voiding and continence.
Urethroplasty after Urethral Urolume Stent: an International Multicenter Experience
Urology, 2018
To evaluate the outcomes and factors affecting success of urethroplasty in patients with stricture recurrence after Urolume® urethral stent. Retrospective international multicenter study on patients treated with urethral reconstruction after Urolume® stent. Stricture and stent length, time between urethral stent insertion and urethroplasty, age, mode of stent retrieval, type of urethroplasty, complications and baseline and post-urethroplasty voiding parameters were analyzed. Successful outcome was defined as standard voiding, without need of any postoperative adjunctive procedure. Sixty-three patients were included. Stent was removed at urethroplasty in 61 patients. Reconstruction technique was excision and primary anastomosis in 14(22.2%), dorsal onlay buccal mucosa graft (BMG) 9(14.3%), ventral onlay BMG 6(9.5%), dorso-lateral onlay BMG 9(14.3%), ventral onlay plus dorsal inlay BMG 3(4.8%), augmented anastomosis 5(7.9%), pedicled flap urethroplasty 6(9.5%), 2-stage procedure 4(6.4...
Urethral Stents. Indications, Complications and Adverse Effects
Urinary Stents, 2022
Urine produced in kidneys should freely flow out through the ureters, bladder and urethra. Bladder outlet obstruction [BOO] by benign or malignant processes leads to Lower urinary tract symptoms [LUTS], reduced quality of life, and if left untreated it may damage kidneys and lead to loss of kidney function. BOO in the urethra is more prevalent in males compared to females, as the male urethra is much longer and can be caused by several conditions at different anatomical locations. In this review we focus on the entire male urethra. Since no stents are used in female urethral obstructions, they will be excluded from this review [1]. At the prostatic urethra, the major cause for BOO is benign prostatic hyperplasia [BPH]. About 105 million men are affected globally of BPH [2]. Development of BPH typically begins after the age of 40, around half of males aged 50 and over are affected [3] with the majority [~90%] of males affected after the age of 80 [3]. Prostate cancer can also lead to BOO. More distal in the urethra, the major cause of
Acta chirurgica iugoslavica, 2014
Aim of this study is to judge effectiveness of new design, temporary, cover, metal selective urethral Allium stents in lower urinary tract symptoms treatment concerning all peri and post procedural complications. Material and methods: We observed group of 40 patients with longstanding history of lower urinary tract symptom, in which outflow obstruction was localized in bulbar urethra in 24 pts and in prostatic urethra in 13 pts. Residual voiding volume and prostate volume measurements by ultrasonography, urethrocystography, urine culture and uroflowmetry (bulbar urethra stricture PTS) were done before stent insertion. Procedure was done in all cases but one in ambulatory conditions, under local anesthesia with oral antibiotics administration day before and 5 days after. Objective and subjective parameters of stent effectiveness were estimated and statistically revealed. Results: Majority of pts (32/40) were satisfied with all the aspects of the procedure and with quality of life whi...
Experience with Urethral Stent Explantation
Journal of Urology, 2003
Purpose: We examined the timing, causes and results of the explantation of UroLume (American Medical Systems, Minnetonka, Minnesota) urethral stents.
American Journal of Roentgenology, 2007
The purpose of this study was to evaluate the long-term clinical efficacy of temporary placement of covered retrievable stents in the management of recurrent urethral strictures. MATERIALS AND METHODS. During the period December 1998-December 2005, 32 men and one adolescent boy (mean age, 48.6 years; range, 16-73 years) with recurrent urethral strictures underwent fluoroscopically guided insertion of a total of 68 stents. Patients without complications underwent elective stent removal 2 or 4 months after stent insertion. Rates of clinical success (long-term clinical and radiographic resolution of urethral strictures) were assessed. The Mann-Whitney U test was used to compare the duration of stent placement in patients with long-term clinical resolution with that in patients with stricture relapse. RESULTS. Clinical success was achieved in 18 (55%) of the 33 patients. The mean duration of stent placement in patients with clinical success was significantly different from that in patients who had recurrences (p < 0.0001). Stricture relapse did not occur in only four (20%) of 20 cases of stent placement for 2 months. All 14 stent placements lasting at least 4 months resulted in long-term resolution after a mean follow-up period of 3.6 years. The most common complications necessitating early stent removal were stent migration (33.8% of stents) and tissue hyperplasia (20.6% of stents). CONCLUSION. Placement of a covered retrievable stent for a minimum of 4 months is effective in inducing long-term resolution of refractory urethral strictures. Stent migration remains the largest obstacle in achieving adequate duration of stent placement.
Long-term results of a self-expanding wallstent in the treatment of urethral stricture
BJU International, 2004
To report the long-term outcome over 12 years of using the urethral Urolume wallstent (AMS, Minnetonka, MI, USA) for treating recurrent bulbar urethral stricture disease. The case-notes of 60 consecutive men with urethral Urolume wallstents placed for treating recurrent bulbar strictures were reviewed retrospectively. Information was collected on patient demographics, stricture aetiology, stent-related complications and the need for further surgery to treat stent- or stricture-related complications. The mean (range) age of the men was 58 (32-76) years. The most common cause of stricture was iatrogenic, arising after previous endoscopic surgery or after an indwelling catheter (45%). Thirty-five men had complications, with re-operation required in 27 (45%) of them. The most frequent nonsurgical complications were post-micturition dribble (32%) and recurrent urinary tract infections (27%). The most common surgical interventions required were transurethral resection of obstructing stent hyperplasia (32%), urethral dilatation or urethrotomy for stent obstruction or stricture (25%) and endoscopic litholapaxy for stent encrustation or stone (17%). The Urolume wallstent should only be used in patients who are unfit for or who refuse a bulbar urethroplasty.
Material Characteristic of an Innovative Stent for the Treatment of Urethral Stenosis
Acta Mechanica et Automatica
The appropriate development and customisation of the stent to the urethral tissues requires the determination of many factors such as strength and degradation. Given the distinctive conditions of urethral tissues, it is important that the design of the stent be properly developed. The selection of a stent material requires knowing its material characteristics and verifying that they are suitable for the future implantation site. In the present study, the development of a polydioxanone (PDO)-based stent was undertaken. The PDO material was fabricated using an additive technique – 3D printing. Then, in vitro tests were performed to determine the degradation time of the material under conditions simulating an aggressive urinary environment. The changes in the parameters of mechanical properties before and after the degradation period were determined, and the changes in the structure of the material before and after degradation were observed. Numerical analysis was performed for the pro...