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Related Experiment Videos

Histological changes associated with long-term urethral stents

D M Bailey1, S J Foley, J P McFarlane

  • 1Department of Histopathology, King's College School of Medicine and Dentistry, London, UK.

British Journal of Urology
|June 20, 1998
PubMed
Summary

Long-term urethral stents cause polypoid hyperplasia and inflammation, leading to stent obstruction in many patients. Further study is needed to rule out cancer risk with keratinizing squamous metaplasia.

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Area of Science:

  • Urology
  • Pathology
  • Biomaterials Science

Background:

  • Urinary tract stents are used to manage various conditions including benign prostatic hyperplasia, recurrent strictures, and detrusor-sphincter dyssynergia.
  • Long-term indwelling stents can lead to significant tissue reactions and complications.

Purpose of the Study:

  • To histologically evaluate tissue changes in patients with long-term external sphincter, prostatic, and urethral stents.
  • To understand the incorporation process of stents into the urethral wall and associated pathologies.

Main Methods:

  • Histological examination of urethral mucosa overlying indwelling stents in 18 patients (mean indwelling time 3.5 years).
  • Biopsies were taken from mucosa over patent stents and from two stents with occluded lumens.

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  • Patients had stents for detrusor-sphincter dyssynergia, benign prostatic hyperplasia, or recurrent urethral strictures.

    • Main Results:

    • Polypoid hyperplasia of the mucosa was observed in 11 of 18 patients, integrating with the stent mesh.
    • Chronic inflammation, often with plasma cell infiltrates, was prevalent (15 patients).
    • Squamous metaplasia (non-keratinizing and hyperkeratotic), foreign-body granulomas, and microabscesses were also noted.

    Conclusions:

    • Urinary stents become incorporated into the urethral wall via polypoid hyperplasia, leading to focal stent covering and inflammatory responses.
    • Urothelial and connective tissue proliferation can obstruct stent lumens, as seen in 9 patients.
    • While no malignancy was found, long-term surveillance is recommended for patients with keratinizing squamous metaplasia due to potential cancer risk.