Effect of a Temporary Thermo-Expandable Stent on Urethral Patency after Dilation or Internal Urethrotomy of Recurrent Bulbar Urethral Stricture: Results from the Memokath™ 044TW One-Year Randomized Trial
The Journal of urology | 15 Jan 2013
GH Jordan, H Wessells, C Secrest, J Squadrito, J McAninch, L Levine and M van der Burght
PURPOSE: The long-term success rate of dilation and/or internal urethrotomy is low in cases of recurrent urethral stricture disease. This study investigated the Memokath™044TW stent’s ability to maintain urethral patency after dilation or internal urethrotomy of recurrent urethral stricture. MATERIALS AND METHODS: Ninety-two patients with recurrent bulbar urethral strictures (mean length 2.7 cm) were treated with dilation or internal urethrotomy and randomized to short-term urethral catheter diversion (N=29) or insertion of a Memokath™044 stent (N=63). The primary endpoint was urethral patency as assessed by the passage of a calibrated endoscope. Secondary endpoints included urinary symptoms and uroflowmetry parameters. Stents were scheduled to remain in situ 12 months. RESULTS: The rate of successful stent insertion was 93.6% (59/63). The stented patients maintained patency significantly longer than controls (292 days vs. 84 days (median), p<0.001). The patency was reflected in significantly improved uroflowmetry and symptom scores. The stent was removed in 100% of patients. The most frequently noted side-effects in the stented patients were bacteriuria, hematuria, and penile pain - all usually mild and transient. There were no differences in sexual function between the Memokath and control patients. Stent dislocation and occlusion were observed in eight and three patients, respectively. CONCLUSIONS: Patients with recurrent bulbar urethral strictures treated with dilation or urethrotomy and a Memokath™044 stent maintained urethral patency significantly longer than those treated with dilation or urethrotomy alone. The stent's side-effect profile was favorable. The stent was straightforward to insert and was removed without difficulty - even after long-term placement.
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