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Questions posted in the
The Urology Forum have been answered by urologists from Henry Ford Health System and by Dr. Kevin Pho.
Question Title: Reformation of stricture after placement of Endourethral StentForum: The Urology Forum
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What can be done after the failure of a stent? Since having had a stint placed (aprox 20 months) I have had two laser treatments (the last one was over 2 1/2 hours in length) and dilitations. The stricture is now almost totally closed again. (I have watched the scope and the scar tissue is extermly fiberious.) A inflatable dilator has been suggested and was tried after the strictue had closed to less than 50% of maximum flow ther was no relief in fact flow did decrease slightly after dilitation. ---------------------------------------------------------------------------- Dear Al, Thanks for your question. From your description, it sounds as though your best option is to undergo urethral reconstruction. The stent needs to be removed and given the amount of associated inflammation that I suspect exists at this time, the affected portion of your urethra also needs to be removed and non-hair bearing genital skin or another available tissue used to replace the area removed. Sometimes the area can be removed and the remaining urethra can be freed-up to fill the gap. Much depends on the location and extent of the strictured, and your overall medical condition and age. Steroid injections, further laser ablation, direct vision internal urethrotomies are procedures that are unlikely to provide long term cure. This information is provided for general medical information purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. Dr. Liroff at our institution has interest in urethral stricture disease and reconstruction. If you would like to make an appointment please call us at (1-800-653-6568). We can also arrange local accommodations through this number if this is your need. Please bring any x-rays [and pathology slides] (not just the reports) as well as any physicians’ notes and lab test results that you may be able to obtain. These will help us greatly. HFHS M.D.-SAL
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