Video Section

International Braz J Urol
Official Journal of the Brazilian Society of Urology

Vol. 40 (4): 576-577, July . August, 2014
Transurethral resection of fibrotic scar tissue combined with temporary urethral stent placement for patients with in anterior urethral stricture
Cheol Yong Yoon , Ji Yun Chae, Jong Wook Kim , Jin Wook Kim , Mi Mi Oh, Hong Seok Park , Du Geon Moon, Jun Cheon, Jeong Gu Lee, Jae Jong Kim
1 Department of Urology and Center of Regenerative Medicine, College of Medicine, Korea University, Seoul, Korea
Introduction: Fibrotic scar formation is a main cause of recurrent urethral stricture after initial management with direct vision internal urethrotomy (DVIU). In the present study, we devised a new technique of combined the transurethral resection of fibrotic scar tissue and temporary urethral stenting, using a thermo-expandable urethral stent. MemokathTM 044TW) in patients with anterior urethral stricture. Materials and Methods: As a first step, multiple incisions were made around stricture site with cold-cutting knife and Collins knife electrode to release a stricture band. Fibrotic tissue was then resected with a 13Fr pediatric resectoscope before deployment of a MemokathTM 044TW stent (40 60mm) on a pre-mounted sheath using 0 cystoscopy. Stents were removed within 12 months after initial placement. Results: We performed this technique on 11 consecutive patients with initial (n = 4) and recurrent (n = 7) anterior urethral stricture (April 2009 February 2013). At 18.9 months of mean follow-up (12-34 months), mean Qmax 7.83.9ml/sec vs 16.8 4.8ml/sec, p < 0.001), IPSS (20.7 vs 12.5, p = 0.001 ), and QoL score (4.7 vs 2.2, p < 0.001) were significantly improved. There were no significant procedure-related complications except two cases of tissue ingrowth at the edge of stent, which were amenable by transurethral resection. In 7 patients, an average 1.4 times (1-5 times) of palliative urethral dilatation was carried out and no patients underwent open surgical urethroplasty during the follow-up period. Conclusion: Combined transurethral resection and temporary urethral stenting is a effective therapeutic option for anterior urethral stricture. Further investigations to determine the long-term effects, and safety profile of this new technique are warranted.

Key Words:
Int Braz J Urol. 2014; 40 (Video #11): 576-7