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요도 스텐트에 실패한 요도협착 환자에서 내요도절개술을 시행 했을 때의 배뇨 및 성 기능의 효과 |
| 영남대학교 의과대학 비뇨의학교실 |
| 김영욱, 장준보, 최재영, 고영휘, 송필현, 문기학, 정희창 |
INTRODUCTION AND OBJECTIVES
A thermo-expandable stent (MemokathTM, Pnn Medical, Denmark) have currently used for recurrent bulbar urethral stricture. However, many complications which needed removal of stent, such as recurrent stricture, migration of stent, encrustation, and infection, have been reported in some studies and re-surgical treatment as urethroplasty or visual internal urethrotomy have been needed in many cases. Thus, we investigated the outcomes of voiding parameters and sexual function of visual internal urethrotomy after removal of urethral stent (MemokathTM).
METHODS
From January 2011 and December 2015, thirty-five patients who underwent visual internal urethrotomy immediately after removal of urethral stent (MemokathTM) because of any complications within 1 year were included in this study. Successful outcome was defined as normal voiding pattern, without need of any postoperative procedure until 3 years after surgery. We analyzed voiding parameters, including International Prostate Symptom Score (IPSS), Qmax, and residual urine, and sexual function parameter, using Male Sexual Health Questionnaire (MSHQ) at preoperative, postoperative 1 year, 2 years, and 3 years.
RESULTS
The mean age was 47.5±11.6 years and the mean interval between implantation and removal of urethral stent was 7.4±2.6 months. The complications were included in follows: 25 re-strictures; 5 encrustations; 3 infections; 2 migrations. After removal of stent, all of patients newly had urethral stricture and the mean stricture lengths were 8.4±6.5 mm. The recurrence free survival (RFS) rate was 98.71%, 94.48%, and 87.19% at 1, 2, and 3 years, respectively. No difference in RFS was observed regarding the site of stricture (log-rank, p=0.497). With voiding parameters, total IPSS, QoL, Qmax, and PVR significantly improved after postoperative 1 year (p=0.009, <0.001, <0.001, and 0.01, respectively). In terms of sexual function, erection and satisfaction domain score were significantly improved after postoperative 1 year, compared with urethral stent (p<0.001 and p=0.032, respectively).
CONCLUSIONS
Despite removal of urethral stent (MemokathTM) because of any complications, visual internal urethrotomy immediately after removal of urethral stent is an effective surgical treatment of reconstruction with improvement of sexual and voiding function as well as high success rate. |
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keywords : urethral stent, internal urethrotomy, sexual function |
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