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Management of Recurrent Urethral Strictures with Covered Retrievable Expandable Nitinol Stents: Long-Term Results

Eugene K. Choi1,2, Ho-Young Song1, Ji Hoon Shin1, Jin-Oh Lim1, Hyungkeun Park3 and Choung-Soo Kim3

1 Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Poongnap-2 Dong, Songpa-Gu, 138-736 Seoul, Korea.
2 Weill Medical College of Cornell University, New York, NY.
3 Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.


Figure 1
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  		Fig. 1 —Photograph shows polytetrafluoroethylene-covered retrievable nitinol stent.

 

Figure 2
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  		Fig. 2A —16-year-old boy with history of straddle injury presented with recurrent 2-cm stricture in bulbar urethra. Left anterior oblique retrograde urethrogram shows site of stricture (arrow) before stent placement.

 

Figure 3
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  		Fig. 2B —16-year-old boy with history of straddle injury presented with recurrent 2-cm stricture in bulbar urethra. Left anterior oblique retrograde urethrogram at stent placement shows 4-cm covered retrievable stent (arrow) in bulbar urethra.

 

Figure 4
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  		Fig. 2C —16-year-old boy with history of straddle injury presented with recurrent 2-cm stricture in bulbar urethra. Left anterior oblique retrograde urethrogram 7 weeks after B shows early tissue hyperplasia at distal end of stent (arrow).

 

Figure 5
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  		Fig. 2D —16-year-old boy with history of straddle injury presented with recurrent 2-cm stricture in bulbar urethra. Left anterior oblique retrograde urethrogram shows insertion of overlapping second stent (arrow) at distal end of initial stent (arrowhead). Second stent extended duration of first stent placement to 4 months.

 

Figure 6
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  		Fig. 2E —16-year-old boy with history of straddle injury presented with recurrent 2-cm stricture in bulbar urethra. Left anterior oblique retrograde urethrogram after stent removal shows good passage of contrast material through former stricture site. Patient has been symptom free over 6 years of follow-up.

 

Figure 7
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  		Fig. 3A —60-year-old man with history of traumatic stricture of bulbar urethra underwent stent placement after three failed trials of optical urethrotomy. Left anterior oblique retrograde urethrogram shows site of bulbar stricture (arrow) before stent placement.

 

Figure 8
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  		Fig. 3B —60-year-old man with history of traumatic stricture of bulbar urethra underwent stent placement after three failed trials of optical urethrotomy. Left anterior oblique retrograde urethrogram shows 5-cm-long covered retrievable stent (arrowheads) traversing external sphincter.

 

Figure 9
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  		Fig. 3C —60-year-old man with history of traumatic stricture of bulbar urethra underwent stent placement after three failed trials of optical urethrotomy. Left anterior oblique retrograde urethrogram 4 months after stent placement shows maintained patency of stent despite tissue overgrowth at distal stent end (arrow).

 

Figure 10
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  		Fig. 3D —60-year-old man with history of traumatic stricture of bulbar urethra underwent stent placement after three failed trials of optical urethrotomy. Left anterior oblique retrograde urethrogram obtained 3 years after C shows well-maintained patency at former stricture site. Patient has not had relapse after 4 years of follow-up.

 

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