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Tumors metastasizing to the glans penis are uncommon and a rare occurrence. The majority of the primary tumors are located in the pelvis and they arise from the genitourinary tract and rectum (>75%). We report a 61-year-old man with known metastatic (lymph nodes and maxilla) esophageal cancer who was treated with chemotherapy and referred to urology with phimosis for circumcision. He did not have any other urological or penile complaints. During circumcision the glans penis looked nodular and a biopsy was taken. The histological examination of the biopsy showed metastasis from esophageal primary adenocarcinoma. The case was discussed in a multi-disciplinary meeting and palliative radiotherapy was recommended and commenced.

INTRODUCTION AND OBJECTIVES: The incidence of postrenal transplant ureteric stenosis ranges from 2%‐12%. Currently the gold standard treatment is open revision, but minimally invasive endourological procedures may provide an attractive alternative. We present our data on the successful use of a thermo-expandable, metallic alloy ureteric stent, (Memokath® 051) as a long-term treatment for posttransplant ureteric strictures. METHODS: We retrospectively analysed the medical records of patients undergoing Memokath 051® insertion for ureteric strictures following renal transplantation. The records were reviewed for age, site of stricture, duration of stenting and complications. RESULTS: Seven male patients, mean age 48 (23-74) with strictured or otherwise obstructed ureters following kidney transplantation have been treated with ureteric Memokath (MMK) 051® insertion. At a mean follow up of 3 years, 4 stents were patent and patient’s kidney function has been normal. Average indwelling time of these stents was 31 month. In two patients the stricture extended the whole ureter so that full length MMKs (60mm and 150mm) were inserted; one patient had a 4 cm proximal ureteric stricture which was bridged by a 10 cm MMK, one presented with a blocked, previously inserted Wallstent bridging the stricture through which the Memokath (10cm) was placed. Spontaneous resolution of the stricture without the need for further stenting was seen in two patients: an anastomotic stricture between transplant ureter and a Boari flap resolved spontaneously and the MMK was expelled after 5 month indwelling time. The other patient underwent removal of his MMK due to blockage after 13 month indwelling time - intraoperatively, the stricture showed to be resolved so no further treatment was necessary. In one patient MMK treatment had failed: After extra-anatomical implanted kidney he developed a massively torted, obstructive ureter, which was bridged by a full length Memokath. Due to migration, this was removed after 1 month and replaced with a JJ stent. The overall success rate of Memokath placement was 85% (4 stents patent in situ and 2 spontaneous resolutions of stricture, 1 failure). No other morbidities were recorded and all other patients tolerated the stents well. CONCLUSIONS: Permanent ureteric stenting with the Memokath® 051 is a safe and effective minimally invasive treatment alternative for ureteral strictures after kidney transplantation. It provides an attractive alternative to open surgery and is well tolerated by patients.