Korean J Urol.  2013 Dec;54(12):851-857.

Early Experience With a Thermo-Expandable Stent (Memokath) for the Management of Recurrent Urethral Stricture

• Jung HS
• Kim JW
• Lee JN
• Kim HT
• Yoo ES
• Kim BS

Abstract

PURPOSE
To report our early experience with thermo-expandable urethral stents (Memokath) for the management of recurrent urethral stricture and to assess the efficacy of urethral stents.
MATERIALS AND METHODS
Between March 2012 and February 2013, 13 patients with recurrent urethral stricture after several attempts with direct visual internal urethrotomy (DVIU) or failed urethroplasty underwent DVIU with thermally expandable, nickel-titanium alloy urethral stent (Memokath) insertion. Follow-up study time points were at 1, 3, 6, 9, and 12 months after stent insertion. Follow-up evaluation included uroflowmetry, retrograde urethrogram, plain radiography, and urinalysis.
RESULTS
The mean patient age was 47.7 years (range, 18 to 74 years). The mean urethral stricture length was 5.54 cm (range, 1 to 12 cm). There were six patients with bulbar, four patients with proximal penile, one patient with distal penile, and two patients with whole penile urethral strictures, respectively. The overall success rate was 69% (9/13) and the mean postoperative peak flow rate was 17.7 mL/s (range, 6 to 28 mL/s). Major complications occurred in four patients including one patient (7.7%) with urethrocutaneous fistula induced by the stent and three patients with urethral hyperplasia. The mean follow-up duration was 8.4 months.
CONCLUSIONS
Our initial clinical experience indicates that thermo-expandable stents can be another temporary management option for recurrent urethral stricture patients who are unfit for or refuse urethroplasty. Distal or whole penile urethral stricture can be factors predicting poor results.

Keyword

Stents; Urethral strictures

MeSH Terms

Alloys
Fistula
Follow-Up Studies
Humans
Hyperplasia
Nickel
Radiography
Stents*
Titanium
Urethral Stricture*
Alloys
Nickel
Titanium

Figure

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  FIG. 1 (A) Single-ended Memokath (Pnn Medical, Kvistgaard, Denmark) stent. (B) Double-ended Memokath stent.

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  FIG. 2 Retrograde urethrogram after insertion of Memokath (Pnn Medical, Kvistgaard, Denmark) stent.

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  FIG. 3 Cystourethroscopic finding of urethral hyperplasia at distal penile urethra at postoperative 8 months.

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  FIG. 4 Urethrocutaneous stent perforation at postoperative 1 month.

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