UROLOGICAL SURVEY
RECONSTRUCTIVE UROLOGY
Long-term results of permanent urethral stent Memotherm implantation in the management of recurrent bulbar urethral stenosis
Sertcelik MN; Bozkurt IH; Yalcinkaya F; Zengin K
Ankara Diskapi Yildirim Beyazit Training and Research Hospital 1. Urology Clinic, Ankara, and Department of Urology, Karaman State Hospital, Karaman, Turkey
BJU Int. 2011; 108: 1839-42.
STUDY TYPE- Therapy (case series) Level of Evidence4 What's known on the subject? and What does the study add? Milroy reported 84% success at a mean of 4.5 years follow-up by usage of a permanently implantable "urolume" spent in 1993. Study Type - Therapy (case series) Level of Evidence Memotherm was developed later, especially for urologic use. Our study is one of the largest in this urea, with a high number of patients and a long follow-up period.
OBJECTIVE: To evaluate the effectiveness and long-term results of permanent urethral stent (Memotherm) implantation in the treatment of recurrent bulbar urethral stricture.
PATIENTS AND METHODS: In all, 47 patients with a history of previous unsuccessful treatment for bulbar urethral stricture were treated using Memotherm bulbar urethral stents between 1998 and 2002. Long-term follow-up data was analysed and discussed.
RESULTS: At the end of the 7-year period 37 of 47 patients (78.7%) had been treated successfully. Post-micturition dribbling incontinence lasting up to 3 months after stent placement occurred in 32 (68.1%) patients, but this was reduced to only seven patients (14.9%) by the 7-year follow-up. There was stress incontinence of various severities in nine (19.2%) patients at the 1-year follow-up. These patients were those who had stenosed urethral segments adjacent to the external sphincter. At the long-term follow-up < 10% of the patients had stress incontinence complaints.
CONCLUSION: Memotherm is a good treatment option in patients with recurrent bulbar urethral stricture of any cause.
Editorial Comment
We do not yet have a urethral stent that is ready for broad application. The authors describe their experience with Memotherm. This is a stent that contracts in cold water and expands after being placed in the urethra at body temperature. Removing it is fairly easy after irrigating the urethra with cold water. This is a big improvement over the Urolume stent which is very difficult to extract. Still the results reported herein show that there is still much room for improvement in the design of urethral stents, or that stents hold limited promise in urethral stricture management. Approximately half of the patients required secondary procedures for restenosis or "hyperplastic ingrowth" inside the stent. The true future of stents likely lies in drug-elutingvstents or temporary stents acting as scaffolds for engineered tissue ingrowth.
Dr. Sean P. Elliott
Department of Urology Surgery
University of Minnesota
Minneapolis, Minnesota, USA
E-mail: selliott@umn.edu
Publication Dates
-
Publication in this collection
02 Mar 2012 -
Date of issue
Dec 2011
