V7-13: Transurethral resection of fibrotic scar in advance of thermo-expandable stenting for distal urethral stricture

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Introductions and Objectives
Intraurethral fibrotic scar formation accompanied by spongiofibrosis is a main cause recurrent urethral stricture after initial management with direct vision internal urethrotomy (DVIU) or dilatation. Here, we report on technical feasibility and short-term outcome of a new technique: Transurethral resection of pre-formed fibrotic tissue before the placement of a thermo-expandable urethral stent for distal urethral stricture.

Methods
The clinical records of 11 consecutive patients with distal urethra stricture (9 bulbous, 3 penile) were retrospectively reviewed (April 2011 – February 2013). As a first step, all patients were treated with transurethral resection of fibrotic tissue using 13Fr pediatric resectoscope to the level of normal looking corpus spongiosum and, then thermo-expandable urethral stents (MemokathTM 044TW) were deployed according to the conventional protocol. Stents were removed in 6-12 months of initial placement and urethral patency was determined in terms of the ability of pass 17Fr cystoscopy and the normal range of uroflowmetry (maximum flow rate (Qmax) ¡Ã 15ml/sec). Also operational feasibility of new technique with focus on peri- and post-operative complication was accessed.

Results
Mean age of patients and operation time were 58.9 (32-83) years and 84.5 (30-110) minutes respectively. Mean follow-up duration was 14.9 (7-30) months and during this period in 9 from 11 patients, urethral stents were removed. Mean post-op Qmax (18.7¡¾5.7ml/sec) was significantly higher than that of pre-op (10.5¡¾2.6ml/sec, p
Conclusions
Combined transurethral resection of fibrotic scar tissue and temporary urethral stenting is feasible, safe, and efficient technique for distal urethral stricture.

Funding: none