Recurrent vesicourethal stenosis after radical prostatectomy: how to treat it?

The UroLume stent revisited: the Duke experience

OBJECTIVE

To describe our experience with the UroLume Urethral Stent, showing that it provides a viable option for the devastated, obstructed outlet after prostate cancer treatment.

METHODS

We conducted an institutional review board-approved retrospective study of all men at our facility who underwent placement of the UroLume stent from January 2001 to January 2012. Records were reviewed for patient demographics, outcomes, and complications. We specifically evaluated urinary continence, ingrowth of the UroLume stent, need for repeat operations, and complications related to this treatment including artificial urinary sphincter (AUS) erosion.

RESULTS

Forty-five men underwent placement of the UroLume stent with an average follow-up of 55.8 months. Of these, 41 had simultaneous or subsequent placement of an AUS with an overall continence rate of 35 of 45 (78%). Ingrowth was seen in 16 of 45 (36%) and AUS erosion in 8 of 41 (19.5%). Of the 16 patients treated for ingrowth, the average number of treatments was 2.7 per patient. There was no association between treatment for ingrowth and rate of AUS erosion (P = .92).

CONCLUSION

Although no longer commercially available, our long-term data indicate that the UroLume was a reasonable minimally invasive treatment option for the devastated, obstructed outlet providing a reasonable rate of need for subsequent interventions. The UroLume maintains patency of the urethral lumen, which usually results in incontinence, but this can be managed with placement of the AUS. The alternative open operative reconstructive options have similar limitations with possibly greater morbidity.