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Hu K, Hou Z, Huang Y, Li X, Li X, Yang L. Recent development and future application of biodegradable ureteral stents. Front Bioeng Biotechnol 2024; 12:1373130. [PMID: 38572363 PMCID: PMC10987965 DOI: 10.3389/fbioe.2024.1373130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/06/2024] [Indexed: 04/05/2024] Open
Abstract
Ureteral stenting is a common clinical procedure for the treatment of upper urinary tract disorders, including conditions such as urinary tract infections, tumors, stones, and inflammation. Maintaining normal renal function by preventing and treating ureteral obstruction is the primary goal of this procedure. However, the use of ureteral stents is associated with adverse effects, including surface crusting, bacterial adhesion, and lower urinary tract symptoms (LUTS) after implantation. Recognizing the need to reduce the complications associated with permanent ureteral stent placement, there is a growing interest among both physicians and patients in the use of biodegradable ureteral stents (BUS). The evolution of stent materials and the exploration of different stent coatings have given these devices different roles tailored to different clinical needs, including anticolithic, antibacterial, antitumor, antinociceptive, and others. This review examines recent advances in BUS within the last 5 years, providing an in-depth analysis of their characteristics and performance. In addition, we present prospective insights into the future applications of BUS in clinical settings.
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Affiliation(s)
- Ke Hu
- Department of Urology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
- Research Center for Biomedical Materials, Engineering Research Center of Ministry of Education for Minimally Invasive Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhipeng Hou
- Research Center for Biomedical Materials, Engineering Research Center of Ministry of Education for Minimally Invasive Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yuanbin Huang
- Department of Urology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xueying Li
- College of Computer Science and Engineering, Dalian Minzu University, Dalian, China
| | - Xiancheng Li
- Department of Urology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Liqun Yang
- Research Center for Biomedical Materials, Engineering Research Center of Ministry of Education for Minimally Invasive Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Research Institute for Eugenic Birth and Fertility, China Medical University, Shenyang, China
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Soria F, de La Cruz JE, Fernandez T, Budia A, Serrano Á, Sanchez-Margallo FM. Heparin coating in biodegradable ureteral stents does not decrease bacterial colonization-assessment in ureteral stricture endourological treatment in animal model. Transl Androl Urol 2021; 10:1700-1710. [PMID: 33968658 PMCID: PMC8100852 DOI: 10.21037/tau-21-19] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background We assessed an antireflux biodegradable heparin-coated ureteral stent (BraidStent®-H) in an animal model comparative study after endoscopic treatment of ureteral strictures. Methods A total of 24 female pigs underwent initial endoscopic, nephrosonographic, and contrast fluoroscopy assessment of the urinary tract. Afterward, unilateral laparoscopic ureteral stricture model was performed. Three weeks later, the animals underwent laser endoureterotomy and were randomly assigned to Group-I, in which a double-pigtail stent was placed for 6 weeks, or Group-II, in which a BraidStent®-H was placed. Follow-up was carried out by ultrasonography, contrast fluoroscopy, ureteroscopy, urinalysis and bacteriuria assessment at 3, 6, 12 and 5 months. Finally, a pathological study of the urinary system was performed. Results There were no animals in Group-II with vesicoureteral reflux, with significance at 6 weeks with Group-I. Distal ureteral peristalsis was maintained in 50–75% in Group-II at 1–6 weeks. The 91.7% of stents in Group-II were degraded between 3–6 weeks, without obstructive fragments. Bacteriuria in Group II was 33.3–50% at 3 and 6 weeks. The global success rate by groups was 91.6% and 87.5% in groups I and II, respectively, with no statistical significance. Conclusions BraidStent®-H has been shown to be as efficacious as current ureteral stents in the treatment of benign ureteral strictures following laser endoureterotomy. In addition, it reduces the morbidity associated with current stents and has a homogeneous and predictable degradation rate of about 6 weeks, with no obstructive fragments. Future studies are required to improve the antibacterial coating to reduce BraidStent®-H contamination in view of the results obtained with the heparin coating.
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Affiliation(s)
- Federico Soria
- Endourology Department, Jesús Usón Minimally Invasive Surgery Centre Foundation, Cáceres, Spain
| | - Julia E de La Cruz
- Endourology Department, Jesús Usón Minimally Invasive Surgery Centre Foundation, Cáceres, Spain
| | - Tomás Fernandez
- Urology Department, University Hospital Morales Meseguer, Murcia, Spain
| | - Alberto Budia
- Urology Department, University Hospital La Fe, Valencia, Spain
| | - Álvaro Serrano
- Urology Department, University Hospital Clínico San Carlos, Madrid, Spain
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Soria F, de la Cruz JE, Budia A, Serrano A, Galan-Llopis JA, Sanchez-Margallo FM. Experimental Assessment of New Generation of Ureteral Stents: Biodegradable and Antireflux Properties. J Endourol 2021; 34:359-365. [PMID: 31931610 DOI: 10.1089/end.2019.0493] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Objective: The aim was to assess a new biodegradable and antireflux intraureteral stent (BraidStent®) design in a swine model after ureteral laparoscopic operation. Materials and Methods: A total of 24 female pigs underwent initial endoscopic, nephrosonographic, and contrast fluoroscopy assessment of the urinary tract. Afterward, unilateral ureteropelvic junction obstruction was performed by laparoscopic approach. Six weeks later, the animals underwent laparoscopic Anderson-Hynes pyeloplasty, and were randomly assigned to Group-I, in which a double-pigtail ureteral stent was inserted for 6 weeks, or Group-II, in which a BraidStent®, a biodegradable intraureteral stent design, was placed. Follow-up assessments were performed at 3 and 6 weeks and 5 months. Results: In terms of therapeutic success, complete resolution was observed in 91.6% of Group-I animals and 88.8% in Group-II. No evidence of vesicoureteral reflux (VUR) was observed in Group-II animals and statistical significance in VUR and ureteral orifice damage were observed between groups. BraidStent® degradation occurred in a controlled manner between 3 and 6 weeks, without obstructive fragments. Distal ureteral peristalsis was maintained in 66.6% and 83.3% in Group-II at 3 and 6 weeks of follow-up, respectively. In Group-II, the positive bacteriuria rate was 41.6% and the migration rate 25%. Pathological assessment showed a significant improvement in ureteral healing in Group-II vs Group-I. Conclusions: The results of this comparative study in a porcine model indicate that the intraureteral BraidStent performed similarly to conventional ureteral stents. It avoids complete ureteral length intubation, the adverse effects associated with conventional ureteral stents, and maintains a high level of distal ureteral peristalsis. Moreover, the BraidStent® exhibited a predictable and controlled degradation rate and did not cause any obstructive fragments. However, further studies are needed to improve the anchoring system and reduce the risk of bacterial colonization.
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Affiliation(s)
- Federico Soria
- Endourology-Endoscopy Department, Minimally Invasive Surgery Centre Jesús Usón, Cáceres, Spain
| | - Julia E de la Cruz
- Endourology-Endoscopy Department, Minimally Invasive Surgery Centre Jesús Usón, Cáceres, Spain
| | - Alberto Budia
- Department of Urology, University Hospital La Fe, Valencia, Spain
| | - Alvaro Serrano
- Department of Urology, University Hospital Clínico San Carlos, Madrid, Spain
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Campo I, Valentino M, Sidhu PS, Magi Meconi L, Van Nieuwenhove S, Cova MA, Derchi LE, Bertolotto M. Nonscrotal Causes of Acute Scrotum. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:597-605. [PMID: 32790121 DOI: 10.1002/jum.15431] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 07/03/2020] [Accepted: 07/05/2020] [Indexed: 06/11/2023]
Abstract
Acute scrotum is characterized by intense acute scrotal pain, which may be associated with other symptoms and signs such as abdominal pain, inflammation, and fever. Many pathologic conditions can present in this way, most which involve the scrotal contents. Nonscrotal conditions, however, can rarely present clinically only as acute scrotum: among them, renal colic, aneurysm rupture or other causes of retroperitoneal hemorrhage, primary abdominal or pelvic tumors and metastases, pancreatitis, pelvic inflammation, and muscle injuries. The pathophysiologic characteristics of the clinical presentation, clues for diagnosis, and imaging features of a series of nonscrotal lesions presenting clinically with acute scrotal pain are herein reported and illustrated. In patients presenting with acute scrotal symptoms and normal scrotal ultrasound findings, nonscrotal causes of acute scrotal pain should be considered in the differential diagnosis. Therefore, an ultrasound investigation of the abdomen, groin, and thighs is indicated.
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Affiliation(s)
- Irene Campo
- Department of Radiology, Ospedale Civile di Conegliano, Conegliano, Italy
| | - Massimo Valentino
- Department of Radiology, Ospedale di Tolmezzo, Azienda Sanitaria Universitaria Friuli Centrale, Tolmezzo, Italy
| | - Paul S Sidhu
- Department of Radiology, King's College Hospital National Health Service Foundation Trust, London, UK
| | - Luca Magi Meconi
- Department of Radiology, University of Trieste, Ospedale di Cattinara, Trieste, Italy
| | | | - Maria Assunta Cova
- Department of Radiology, University of Trieste, Ospedale di Cattinara, Trieste, Italy
| | - Lorenzo E Derchi
- Department of Health Sciences, Radiology Section, University of Genoa, Genoa, Italy
| | - Michele Bertolotto
- Department of Radiology, University of Trieste, Ospedale di Cattinara, Trieste, Italy
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Soria F, de La Cruz JE, Caballero-Romeu JP, Pamplona M, Pérez-Fentes D, Resel-Folskerma L, Sanchez-Margallo FM. Comparative assessment of biodegradable-antireflux heparine coated ureteral stent: animal model study. BMC Urol 2021; 21:32. [PMID: 33639905 PMCID: PMC7916282 DOI: 10.1186/s12894-021-00802-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/18/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Double J ureteral stents are widely used on urological patients to provide drainage of the upper urinary tract. Unfourtunately, ureteral stents are not free from complications, as bacterial colonization and require a second procedure for removal. The purpose of the current comparative experimental study is to evaluate a new heparin-coated biodegradable antireflux ureteral stent (BraidStent®-H) to prevent urinary bacterial colonization. METHODS A total of 24 female pigs were underwent determination of bacteriuria and nephrosonographic, endoscopic and contrast fluoroscopy assessment of the urinary tract. Afterward, were randomly assigned animals to Group-I, in which a 5Fr double-pigtail ureteral stent was placed for 6 weeks, or Group-II, in which a BraidStent®-H was placed. Follow-up assessments were performed at 1, 3, 6, 8, 12 weeks. The final follow-up includes the above methods and an exhaustive pathological study of the urinary tract was accomplished after 20 weeks. RESULTS Bacteriuria findings in the first 48 h were significant between groups at 6 h and 12 h. Asymptomatic bacteriuria does not reach 100% of the animals in Group-II until 48 h versus Group-I where it appears at 6 h. The weekly bacteriuria mean rate was 27.7% and 44.4% in Group I and II respectively, without statistical significance. In Group II there were no animals with vesicoureteral reflux, with statistical significance at 3 and 6 weeks with Group-I. The 91.2% of stents in Group-II were degraded between 3 and 6 weeks, without obstructive fragments. Distal ureteral peristalsis was maintained in 66.6-75% in Group-II at 1-6 weeks. CONCLUSIONS The heparin coating of BraidStent® allows an early decrease of bacterial colonization, but its effectiveness is low at the long term. Heparin coating did not affect scheduled degradation rate or size of stents fragments. BraidStent®-H avoids the side effects associated with current ureteral stents, thus should cause less discomfort to patients.
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Affiliation(s)
- Federico Soria
- Endoscopy-Endourology Department, Jesús Usón Minimally Invasive Surgery Centre Foundation, Carretera N-521, Km. 41.8, C.P.10071, Cáceres, Spain.
| | - Julia E de La Cruz
- Endoscopy-Endourology Department, Jesús Usón Minimally Invasive Surgery Centre Foundation, Cáceres, Spain
| | - Juan Pablo Caballero-Romeu
- Urology Department, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL Foundation), Alicante, Spain
| | - Manuel Pamplona
- Urology Department, 12 de Octubre University Hospital, Madrid, Spain
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Krughoff K, Anderson FL, Palisoul S, Young AL, R Pettus J, L Moodie K, Ogomo C, S Tau S, A Moses R, Havrda MC, R Chavez D. The effect of botulinum toxin on ureteral inflammation. World J Urol 2020; 39:2197-2204. [PMID: 32696129 DOI: 10.1007/s00345-020-03365-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/11/2020] [Indexed: 10/23/2022] Open
Abstract
PURPOSE The impact of onabotulinum toxin type A (BoNT-A) on bladder afferent nerve pathways and chemosensory functions is an active area of investigation. There may be a role for BoNT-A in disorders of the ureter; however, no histologic studies have assessed the effects of BoNT-A on ureteral tissue. Our objective was to develop an animal model of ureteral inflammation and determine the impact of ureteral BoNT-A instillation on known mechanisms of inflammation. METHODS The safety and feasibility of a novel animal model of ureteral inflammation was assessed. Through open cystotomy, the effect of ureteral BoNT-A instillation on inflammation was determined through H&E, masson's trichrome, Ki-67 stain, and prostaglandin E (PGE) synthase expression, a known marker of pain and inflammation in ureteral tissue. Urothelial microstructure was assessed using electron microscopy and standard histologic techniques. RESULTS All experiments were carried to completion, and no systemic signs of botulinum toxicity were seen. BoNT-A exposure was associated with a decrease in PGE synthase expression in a dose-dependent fashion. BoNT-A exposure was not found to impact collagen deposition or cell proliferation. Disruption of tight junctions between urothelial cells was observed under conditions of inflammation. CONCLUSION We describe the feasibility of a novel in vivo model of ureteral inflammation and report the first histologic study of the effects of BoNT-A on the ureter. Preliminary findings show that BoNT-A attenuates ureteral PGE synthase expression under conditions of inflammation. The application of BoNT-A may provide anti-inflammatory and analgesic effects in the context of ureteral disorders.
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Affiliation(s)
- Kevin Krughoff
- Department of Urology, Dartmouth-Hitchcock, 1 Medical Center Dr, Lebanon, NH, USA.
| | - Faith L Anderson
- Department of Molecular and Systems Biology, Geisel School of Medicine At Dartmouth and Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH, USA
| | - Scott Palisoul
- Department of Pathology, Dartmouth-Hitchcock, 1 Medical Center Dr, Lebanon, NH, USA
| | - Alison L Young
- Department of Molecular and Systems Biology, Geisel School of Medicine At Dartmouth and Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH, USA
| | - Jason R Pettus
- Department of Pathology, Dartmouth-Hitchcock, 1 Medical Center Dr, Lebanon, NH, USA
| | - Karen L Moodie
- Center for Comparative Medicine and Research, Dartmouth College, Hanover, NH, USA
| | - Christopher Ogomo
- Electron Microscopy, Dartmouth College, 5 Allen St, Hanover, NH, USA
| | - Steven S Tau
- Department of Molecular and Systems Biology, Geisel School of Medicine At Dartmouth and Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH, USA
| | - Rachel A Moses
- Department of Urology, Dartmouth-Hitchcock, 1 Medical Center Dr, Lebanon, NH, USA
| | - Matthew C Havrda
- Department of Molecular and Systems Biology, Geisel School of Medicine At Dartmouth and Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH, USA
| | - David R Chavez
- Department of Urology, Dartmouth-Hitchcock, 1 Medical Center Dr, Lebanon, NH, USA
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Fede C, Porzionato A, Petrelli L, Fan C, Pirri C, Biz C, De Caro R, Stecco C. Fascia and soft tissues innervation in the human hip and their possible role in post-surgical pain. J Orthop Res 2020; 38:1646-1654. [PMID: 32181900 DOI: 10.1002/jor.24665] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 03/06/2020] [Accepted: 03/12/2020] [Indexed: 02/04/2023]
Abstract
Persistent symptoms, most commonly pain, may remain after otherwise successful hip replacement surgery. Innervation of fascia and soft tissues has become increasingly important in etiopathogenesis of pain, but the relative importance of the various anatomical structures in the hip region is still not known. Innervation of skin, superficial adipose tissue, superficial fascia, deep adipose tissue, deep fascia, muscles, capsule, capsule ligament, ligamentum teres, and tendon in the human hip from 11 patients and 2 cadavers were quantified by staining with anti-S100 antibody for myelin-forming Schwann cells, to obtain the percentage of antibody positivity, density and mean diameter of the nerve fibers. The skin was the most highly innervated (0.73% ± 0.37% of positive area in patients; 0.80% ± 0.28% in cadavers); the tendon was the least innervated (0.07% ± 0.01% in patients, 0.07% ± 0.007% in cadavers). The muscles (vasto-lateral and gluteus medius) were the second most innervated structure according the percentage (0.31% ± 0.13% in living humans, 0.30% ± 0.07% in cadavers), but with only a few nerves, with large diameters (mean diameter 36.4 ± 13.4 µm). Instead, the superficial fasciae showed 0.22% ± 0.06% and 0.26% ± 0.05% of positive areas in living humans and cadavers, respectively. Fasciae were invaded by networks of small nerve fibers, revealing a possible role in pain. The superficial fascia was the second most highly innervated tissue after the skin, with a density of 33.0 ± 2.5/cm2 , and a mean nerve sizes of 19.1 ± 7.2 µm. Lastly, the capsule turned out to be poorly innervated (0.09%), showing that its removal does not necessarily lead to painful consequences. Statement of clinical significance: Deeper knowledge about the innervation of the soft tissue in the human hip joint will enhance study and understanding of the best surgical procedures to follow during hip arthroplasty to reduce post-operative pain.
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Affiliation(s)
- Caterina Fede
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Andrea Porzionato
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Lucia Petrelli
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Chenglei Fan
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Carmelo Pirri
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Carlo Biz
- Department of Surgery, Oncology and Gastroenterology, Orthopedic Clinic, University of Padova, Padova, Italy
| | - Raffaele De Caro
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Carla Stecco
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
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Jefferson FA, Okhunov Z, Veneziano D, Rivas JG, Meneses AD, Cacciamani GE, Socarras MR, Wikenhiezer J, Landman J. Precise characterization of urinary tract innervation using three-dimensional reconstruction: A contemporary review. Actas Urol Esp 2019; 43:397-403. [PMID: 31167713 DOI: 10.1016/j.acuro.2019.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 03/19/2019] [Indexed: 11/19/2022]
Abstract
A precise understanding of the autonomic innervation of the urinary tract is crucial to successful management of urologic disease given the important role that neurophysiology plays in genitourinary pathology. Recent studies using a combination of contemporary histopathology and imaging technologies have furthered our understanding of the spatial nerve distribution in the kidneys, ureters, and bladder. The findings of these recent studies may have important clinical applications in expanding our knowledge of the etiology and treatment of disease processes affecting the urinary tract. In this narrative review, our goal is to provide an overview of the autonomic innervation of the urinary tract. Specifically, we aim to provide a three-dimensional gender-specific description of renal, ureteral and vesical innervation. We also highlight some possible opportunities for clinical and investigational application of this new knowledge.
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Affiliation(s)
- F A Jefferson
- Departamento de Urología, Universidad de California, Irvine, Estados Unidos.
| | - Z Okhunov
- Departamento de Urología, Universidad de California, Irvine, Estados Unidos
| | - D Veneziano
- Departamento de Urología, Transplante riñón, Grande Ospedale Metropolitano, Reggio Calabria, Italia
| | - J G Rivas
- Departamento de Urología, Hospital la Paz, Madrid, España
| | - A D Meneses
- Departamento de Urología, São Marcos Hospital, Piauí, Brasil
| | - G E Cacciamani
- Departamento de Urología, Universidad del Sur de California, Los Angeles, Estados Unidos
| | - M R Socarras
- Departamento de Urología, IRCCS San Raffaele Hospital, Ville Turro Division, Milán, Italia
| | - J Wikenhiezer
- Departamento de Anatomía Neurobiológica, Universidad de California, Irvine, Estados Unidos
| | - J Landman
- Departamento de Urología, Universidad de California, Irvine, Estados Unidos
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Initial Evaluation of a Novel Modulated Radiofrequency-based Bladder Denervation Device. Urology 2019; 134:237-242. [PMID: 31539508 DOI: 10.1016/j.urology.2019.08.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/28/2019] [Accepted: 08/28/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine if targeted and modulated radiofrequency ablation (RFA) of the urinary bladder using our novel ablation device (Denerblate) reduces bladder nerve density, potentially leading to a novel strategy for the management of overactive bladder. METHODS Fifteen pigs were divided into 4 groups: control (n = 3), 1-week (n = 4), 4-week (n = 4) and 12-week (n = 4) survival times. Denerblate was deployed on the trigone area of the bladder. Three 240-second cycles of modulated RFA were applied with 30 seconds between cycles. At the end of each survival term, urinary bladders were harvested for histopathologic evaluation. Nerve count and density were manually calculated. RESULTS All procedures were successfully completed, and all animals survived to the desired time points. Mean nerve density (nerves/mm2) was highest in the control and 1-week survival group compared to the 4-week and 12-week groups, both of which demonstrated significant diminishment. Nerve density in the bladder neck at control, 1 week, 4 weeks, and 12 weeks were 1.8, 1.35, 0.87, and 0.12, respectively (P <.001). Nerve density in the bladder trigone area at control, 1 week, 4 weeks, and 12 weeks were 1.5, 0.98, 0.65, and 0.112, respectively (P <.001). Epithelial heat injury was observed in 14.3% at 1 week, 10.7% at 4 weeks, but completely resolved by 12 weeks. CONCLUSION In the porcine model, modulated RFA delivered by our novel device reduced nerve density in the bladder neck and trigone by 88.6% and 88.9% at 12 weeks without evidence of lasting epithelial injury.
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Medical impulsive therapy (MIT): the impact of 1 week of preoperative tamsulosin on deployment of 16-French ureteral access sheaths without preoperative ureteral stent placement. World J Urol 2018; 36:2065-2071. [DOI: 10.1007/s00345-018-2336-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 05/11/2018] [Indexed: 11/27/2022] Open
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