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The purpose of this study is to evaluate if the placement of a temporary urethral stent for up to 12 months, following dilation or internal urethrotomy (cutting open), results in a higher rate of urethral patency during the first year of follow-up when compared to the control group that does not receive a stent.
Patients with bulbar urethral stricture are 2:1 randomised for either urethral dilation or internal urethrotomy with (treatment group) or without (control group) subsequent stenting. All patients are followed for up to one year at 4-6 weeks, 3, 6, 9 and 12 months with visual assessment (urethroscopy) of urethral patency at the treated segment of the urethra. The stent is removed at one year. In case of premature stent removal the patient is also followed for up to one year unless further intervention is decided.
Control patients are offered the stent treatment option if the stricture recurs within the observation period but this group is separately analysed.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Memokath stenting | Device | Urethral Stenting |
| Measure | Description | Time Frame |
|---|---|---|
| Stent/control effectiveness - urethral patency | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Peak urinary flow rate | Immediate | |
| Re-intervention | Short term | |
| Standard survey instruments (QOL, IPSS etc.) |
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Inclusion Criteria:
Males > 21 years of age
Recurrent stricture of the bulbar urethra:
Healthy tissue on both sides of stent
Urinary flow in the abnormal range of the Siroky nomogram.
Written informed consent obtained prior to participation in the study
Patients must be available for all follow-up visits.
Exclusion Criteria:
Strictures:
Inability to enlarge the bulbar urethral stricture to > 26 Fr.
Presence of any other urologic implant
Presence of urethral diverticuli
History of hypospadias repair
Presence or prior history of balanitis xerotica obliterans.
Uncontrolled bleeding disorder
Active urinary tract infection
Any urological condition that would be likely to require additional urethral instrumentation during the period of the investigation, including, but not limited to, benign prostatic hypertrophy requiring treatment; use of alpha blockers; active prostate cancer; an unevaluated elevated prostate-specific antigen (PSA); bladder malignancy; or any recurrent urinary stone formation.
Serum creatinine > 2.0 mg/dl or evidence of progressive renal disease
Concurrent participation in another clinical investigation
Current illness that might confound the results of this investigation
Inability to participate in all of the necessary study activities
Inability or unwillingness to return for all required follow-up visits
Inability or unwillingness to sign the patient informed consent document
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| Name | Affiliation | Role |
|---|---|---|
| Gerry Jordan, MD | Sentara/Engineers and Doctors | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Jack McAninch | San Francisco | California | 94110 | United States | ||
| Mississippi Urology |
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| ID | Term |
|---|---|
| D014525 | Urethral Stricture |
| ID | Term |
|---|---|
| D014524 | Urethral Obstruction |
| D014522 | Urethral Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
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| 15 mos |
| Stent placement success | immediate |
| Stent removal success | immediate |
| Jackson |
| Mississippi |
| 39202 |
| United States |
| Cleveland Clinic | Cleveland | Ohio | 44195 | United States |
| Bryn Mawr Urology | Bryn Mawr | Pennsylvania | 19010 | United States |
| University Urological Associates | Providence | Rhode Island | 02904 | United States |
| Devine-Tidewater Urology | Norfolk | Virginia | 23510 | United States |
| Harborview Medical Center | Seattle | Washington | 98104 | United States |
| D005261 |
| Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |