Holmium laser core through internal urethrotomy with explantation of UroLume stent. An ideal approach for a complicated posterior urethral stricture.

Although the UroLume wallstent has been proven effective in the treatment of recurrent urethral stricture, obstruction may recur in some cases. A likely cause of obstruction is hyperplastic tissue reaction, which may necessitate the removal of the stent. The hyperplastic tissue reaction may be severe, resulting in a completely obliterative stricture. Stent removal with a completely obliterative stricture and the stent in situ is a tedious job, as there is no lumen in which to place the laser fiber to cut the stent wires. We report on a patient in whom a UroLume urethral stent was placed one year ago for post-traumatic recurrent bulbomembranous urethral stricture. The stricture recurred in spite of the stent in place and the lumen was finally completely obliterated. A holmium laser was used for core through internal urethrotomy and the explantation of the stent.