title: Thermo-expandable metallic urethral stents for managing recurrent bulbar urethral strictures: To use or not?
abstract: OBJECTIVE
  To assess the role of temporary thermally expandable urethral stents in maintaining urethral patency in patients with a recurrent bulbar urethral stricture.
  
  
  METHODS
  Twenty-three men with a recurrent bulbar urethral stricture after several attempts at direct visual internal urethrotomy (DVIU) and/or failed urethroplasty were managed with a thermally expandable, biocompatible nickel-titanium alloy urethral stent (Memokath® MK044, Pnn Medical, Kvistgaard, Denmark). The stents were applied by a special mounting device via a rigid urethroscope after DVIU. All patients were followed using plain radiography, uroflowmetry and urine analysis every 3 months for 1 year, and then every 6 months.
  
  
  RESULTS
  The mean (SD) age of the patients was 55.4 (7.3) years and the mean (SD) stricture length was 3.6 (1.2) cm. All patients tolerated the stent, with minimal discomfort in some patients. Four patients (17%) had urinary tract infections, three (13%) had haematuria, three (13%) had obstructed stents due to encrustation, in five (22%) the stent migrated, and two patients had no delayed complications. The mean (SD) follow-up was 17.4 (6.1) months.
  
  
  CONCLUSIONS
  Urethral stenting with nickel-titanium alloy thermally expandable stents can be an acceptable temporary procedure for patients with recurrent bulbar urethral strictures who are unfit for or who refuse urethroplasty. However, they have limitations; the search for an ideal urethral stent continues.
authors.affiliation: Urology Department, Menoufiya University Hospital, Menoufiya, Egypt.
authors.forename: Mohamed M
authors.initials: MM
authors.lastname: Abdallah
authors.affiliation: Urology Department, Menoufiya University Hospital, Menoufiya, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Selim
authors.affiliation: Urology Department, Menoufiya University Hospital, Menoufiya, Egypt.
authors.forename: Tarek
authors.initials: T
authors.lastname: Abdelbakey
keywords: Bulbar urethral stricture; DSD, detrusor sphincter dyssynergia; DVIU, direct visual internal urethrotomy; PVR, postvoid residual (urine); Recurrent stricture; Stents