TREATMENT OF RECURRENT POSTERIOR AND BULBAR URETHRAL STRICTURES WITH EXPANDABLE METALLIC STENTS

PURPOSE: The role of expandable metallic Z stents (non-mesh) in the tr eatment of recurrent posterior and bulbar urethral strictures was eval uated. PATIENTS AND METHODS: Seven men with recurrent posterior/bulbar urethral strictures underwent balloon angioplasty followed by inserti on of two stents in tandem. Retrograde urethrography, micturating cyst ourethrography, and urodynamic evaluation of these patients was done i nitially. RESULTS: Successful dilation and placement of stents was pos sible in all cases. In one patient slight proximal migration of the st ent occurred; terminal dysuria in this patient necessitated stent extr action. In two other patients near total occlusion of the stent by an exuberant fibrous reaction occurred and this required direct vision in ternal urethrotomy in one case and open urethroplasty in the other. Im mediate postprocedure urethrography and urodynamic evaluation showed s ignificant improvement. Five patients continue to show a satisfactory clinical urodynamic response. The follow-up period in this patient gro up ranged from 5 months to 1 year. CONCLUSION: Short-term response (5 months to 1 year) in patients with posterior/bulbar urethral stricture s treated with Z stents appears promising. However, the efficacy of th e procedure-on a longterm basis requires further follow-up and evaluat ion.