Long-term consequences of urethral stents.

The results of the self-expandable urethral stent (Wallstent) in the treatment of urethral strictures were evaluated in 7 patients with a followup of 23 to 31 months. The 4 failures were caused by exuberant fibrotic proliferation in the lumen of the stent, which required further endoscopic treatment in 2 patients and even surgical removal of the stent in 1. In the other 2 patients the fibrotic proliferation was progressive and will require further treatment. In 1 patient there is slowly progressive proliferation and a diminishing urine flow rate, and in 2 the fibrotic proliferation seems to be stable. Early reports on the stent suggest that its use will obviate the necessity for complex surgery of urethral stricture. Strictures involving layers deeper than the urothelium and traumatic strictures are not good indications for the self-expandable stent. As this technology continues to evolve, we must continue to follow these patients closely and be attentive to the possible long-term consequences.