Restenosis within Implanted Urethral Stent in Complicated Urethral Stricture

Abstract

The management of urethral stricture is always a challenge to the urologists. Here we report a case who suffered from pelvic fracture and complete bulbomembranous urethral disruption. After several attempts the endoscopic means failed to restore his urethral continuity. A self-expandable urethral stent 2.5 cm in length was implanted for bulbomembranous urethral stricture 2 cm in length after visual internal urethrotomy and dilatation. The urinary stream decreased 9 months after the stent placement due to ingrowth of granulation tissue at the proximal end of stent lumen. Even endoscopic means for resecting scar tissue or internal urethrotomy could not keep the satisfactory results of urethral patency. Finally, the patient underwent transperineal removal of urethral stent with segmental resection of the stenosed urethra and end-to-end anastomosis one year after implantation with acceptable result. In conclusion, implant of urethral stent cannot resolve all the urethral obstructions. Preoperative selection of the patients and postoperative long-term follow-up are necessary.