Management for Prostate Cancer Treatment Related Posterior Urethral and Bladder Neck Stenosis With Stents

Bradley A ERICKSON; Jack W MCANINCH; Michael L EISENBERG; Samuel L WASHINGTON; Benjamin N BREYER

doi:10.1016/j.juro.2010.09.020

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Management for Prostate Cancer Treatment Related Posterior Urethral and Bladder Neck Stenosis With Stents

Journal article

Peer reviewed

Management for Prostate Cancer Treatment Related Posterior Urethral and Bladder Neck Stenosis With Stents

Bradley A ERICKSON, Jack W MCANINCH, Michael L EISENBERG, Samuel L WASHINGTON and Benjamin N BREYER

The Journal of urology, Vol.185(1), pp.198-203

2011

DOI: 10.1016/j.juro.2010.09.020

PMCID: PMC3557853

PMID: 21074796

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Abstract

Purpose: Prostate cancer treatment has the potential to lead to posterior urethral stricture. These strictures are sometimes recalcitrant to dilation and urethrotomy alone. We present our experience with the Urolume® stent for prostate cancer treatment related stricture. Materials and methods: A total of 38 men with posterior urethral stricture secondary to prostate cancer treatment were treated with Urolume stenting. Stents were placed in all men after aggressive urethrotomy over the entire stricture. A successfully managed stricture was defined as open and stable for greater than 6 months after any necessary secondary procedures. Results: The initial success rate was 47%. After a total of 31 secondary procedures in 19 men, including additional stent placement in 8 (18%), the final success rate was 89% at a mean ± SD followup of 2.3 ± 2.5 years. Four cases (11%) in which treatment failed ultimately requiring urinary diversion (3) or salvage prostatectomy (1). Incontinence was noted in 30 men (82%), of whom 19 (63%) received an artificial urinary sphincter a mean of 7.2 ± 2.4 months after the stent. Subanalysis revealed that irradiated men had longer strictures (3.6 vs 2.0 cm, p = 0.003) and a higher post-stent incontinence rate (96% vs 50%, p < 0.001) than men who underwent prostatectomy alone but the initial failure rate was similar (54% vs 50%, p = 0.4). Conclusions: Urolume stenting is a reasonable option for severe post-prostate cancer treatment stricture when patients are unwilling or unable to undergo open reconstructive surgery. Incontinence should be expected. The need for additional procedures is common and in some men may be required periodically for the lifetime of the stent.

Tumors

Tumors of the urinary system

Urinary tract. Prostate gland

Gynecology. Andrology. Obstetrics

Nephrology. Urinary tract diseases

Biological and medical sciences

Medical sciences

Male genital diseases

Details

Title: Subtitle: Management for Prostate Cancer Treatment Related Posterior Urethral and Bladder Neck Stenosis With Stents
Creators: Bradley A ERICKSON - Department of Urology University of California- San Francisco, San Francisco, California, United States
Jack W MCANINCH - Department of Urology University of California- San Francisco, San Francisco, California, United States
Michael L EISENBERG - Department of Urology University of California- San Francisco, San Francisco, California, United States
Samuel L WASHINGTON - Department of Urology University of California- San Francisco, San Francisco, California, United States
Benjamin N BREYER - Department of Urology University of California- San Francisco, San Francisco, California, United States
Resource Type: Journal article
Publication Details: The Journal of urology, Vol.185(1), pp.198-203
Publisher: Elsevier; New York, NY
DOI: 10.1016/j.juro.2010.09.020
PMID: 21074796
PMCID: PMC3557853
ISSN: 0022-5347
eISSN: 1527-3792
Language: English
Date published: 2011
Academic Unit: Urology
Record Identifier: 9984051732602771

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