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Management - Stents

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There are two types of urethral stents temporary and permanent.  Most are made up of stainless steel or Nitinol.  Absorbable stents made up of Vicryl are also available. 

Indication : recurrent short bulbar stricture. Patient unfit for surgery or refuse a surgery.

Contra indication:  penile urethral stents are painful during erection. Stents inserted into the membranous urethra after core through urethrotomy for pelvic fracture urethral distraction defects also get blocked due to over growth of fibrosis.

The success rate of urethral stents inserted in the bulbar urethra is quoted in region of 80% a stent may migrate distally forming a stricture at the proximal end exposed part of the urethral stent not covered by urothelium may be encrusted with stones.  Overgrowth of excessive epithelization may block the lumen and may need repeated resection.  In those patients where the stent has to be removed endoscopic removal of the stent may be possible with some single wire stents but mesh stents need open surgery for removal and the patient may be left with a long defect in the bulbar urethra and surgical repair of the urethral defect after stent removal may not be easy.

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