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Kutchukian S, Chicaud M, Corrales M, Solano C, Candela L, Doizi S, Bazin D, Traxer O, Panthier F. Ureteral stents: What your eyes can't see! An in vitro study. THE FRENCH JOURNAL OF UROLOGY 2024; 34:102644. [PMID: 38759842 DOI: 10.1016/j.fjurol.2024.102644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/23/2024] [Accepted: 05/06/2024] [Indexed: 05/19/2024]
Abstract
OBJECTIVES To characterize and compare in vitro the surfaces of ureteral stents (STENTS) before utilization. METHODS Our in vitro experiment included six unused STENTS models: three double-pigtail with side orifices (ImaJin and Stenostent [Coloplast©,France], TriaSoft [BostonScientific©,USA]), two double-pigtail without side orifice (Vortek-TumorStent [Coloplast©,France], Urosoft-TumorStent [Bard-Angiomed©,Germany]) and one single-pigtail (J-Fil [Rocamed©,Monaco]). STENTS were made of polyurethane except for ImaJin (silicone). For all STENTS, four parts of the stent were specifically analyzed under high-resolution scanning electron microscopy (HR-SEM,FEI-XL40 [Philips©,France]): surface core, lateral orifice, ureteral loop, and black marking surface. Each experiment was repeated with three different samples from three different stents. STENTS analysis included multiple imperfection searches, defined as irregularities>10μm. RESULTS All STENTS presented imperfections with no discernible differences. Imperfections were mainly located on the stent loop and on the lateral orifice. For STENTS without side orifice (J-Fil, Urosoft) imperfections were also reported, on the beveled cut as well as the distal loop orifice. Marking surfaces examinations found defects in the Urosoft and imperfections in the ImaJin and Stenostent. The Triasoft presented a better smoothness on marking surfaces compared to other STENTS. Additional matter was reported on the loop distal orifice for J-Fil and ImaJin but all STENTS presented irregular cross-sectional aeras. CONCLUSION All ureteral stents are not perfectly smooth even before utilization. Imperfections were noticed regardless to stent composition or shape, and could play a role in the incrustation phenomenon, is association with inner irregularities, infection, and urine composition. Both manufacturing and material could have an impact on the stent external surface's smoothness. LEVEL OF EVIDENCE: 3
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Affiliation(s)
- Stessy Kutchukian
- GRC n(o) 20, groupe de recherche clinique sur la lithiase urinaire, hôpital Tenon, Sorbonne université, 75020 Paris, France; Service d'urologie, hôpital Tenon, Assistance publique-Hôpitaux de Paris, Sorbonne université, 4, rue de la Chine, 75020 Paris, France; PIMM, UMR 8006 CNRS-Arts et métiers ParisTech, 151, boulevard de l'Hôpital, 75013 Paris, France; Service d'urologie, CHU de Poitiers, Poitiers, France.
| | - Marie Chicaud
- GRC n(o) 20, groupe de recherche clinique sur la lithiase urinaire, hôpital Tenon, Sorbonne université, 75020 Paris, France; Service d'urologie, hôpital Tenon, Assistance publique-Hôpitaux de Paris, Sorbonne université, 4, rue de la Chine, 75020 Paris, France; PIMM, UMR 8006 CNRS-Arts et métiers ParisTech, 151, boulevard de l'Hôpital, 75013 Paris, France; Service d'urologie, CHU de Limoges, Limoges, France.
| | - Mariela Corrales
- GRC n(o) 20, groupe de recherche clinique sur la lithiase urinaire, hôpital Tenon, Sorbonne université, 75020 Paris, France; Service d'urologie, hôpital Tenon, Assistance publique-Hôpitaux de Paris, Sorbonne université, 4, rue de la Chine, 75020 Paris, France.
| | - Catalina Solano
- GRC n(o) 20, groupe de recherche clinique sur la lithiase urinaire, hôpital Tenon, Sorbonne université, 75020 Paris, France; Service d'urologie, hôpital Tenon, Assistance publique-Hôpitaux de Paris, Sorbonne université, 4, rue de la Chine, 75020 Paris, France; Department of Endourology, Uroclin SAS Medellin, Colombia.
| | - Luigi Candela
- GRC n(o) 20, groupe de recherche clinique sur la lithiase urinaire, hôpital Tenon, Sorbonne université, 75020 Paris, France; Service d'urologie, hôpital Tenon, Assistance publique-Hôpitaux de Paris, Sorbonne université, 4, rue de la Chine, 75020 Paris, France; Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Vital-Salute San Raffaele University, Milan, Italy.
| | - Steeve Doizi
- GRC n(o) 20, groupe de recherche clinique sur la lithiase urinaire, hôpital Tenon, Sorbonne université, 75020 Paris, France; Service d'urologie, hôpital Tenon, Assistance publique-Hôpitaux de Paris, Sorbonne université, 4, rue de la Chine, 75020 Paris, France; PIMM, UMR 8006 CNRS-Arts et métiers ParisTech, 151, boulevard de l'Hôpital, 75013 Paris, France.
| | - Dominique Bazin
- Laboratoire de chimie physique, CNRS UMR8000, université Paris Saclay, 91405 Orsay, France.
| | - Olivier Traxer
- GRC n(o) 20, groupe de recherche clinique sur la lithiase urinaire, hôpital Tenon, Sorbonne université, 75020 Paris, France; Service d'urologie, hôpital Tenon, Assistance publique-Hôpitaux de Paris, Sorbonne université, 4, rue de la Chine, 75020 Paris, France; PIMM, UMR 8006 CNRS-Arts et métiers ParisTech, 151, boulevard de l'Hôpital, 75013 Paris, France.
| | - Frédéric Panthier
- GRC n(o) 20, groupe de recherche clinique sur la lithiase urinaire, hôpital Tenon, Sorbonne université, 75020 Paris, France; Service d'urologie, hôpital Tenon, Assistance publique-Hôpitaux de Paris, Sorbonne université, 4, rue de la Chine, 75020 Paris, France; PIMM, UMR 8006 CNRS-Arts et métiers ParisTech, 151, boulevard de l'Hôpital, 75013 Paris, France.
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Choi YH, Kang HJ, Kim KW, Jo MS, Islam MD, Kim JS, Jeon SJ, Lee C, Lee SB, Kim MU, Kim HH. Evaluation of renovated double J stents using ureter models with and without stenosis. World J Urol 2024; 42:228. [PMID: 38598022 DOI: 10.1007/s00345-024-04920-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 03/05/2024] [Indexed: 04/11/2024] Open
Abstract
PURPOSE Commercial double J stents (DJS) have a uniform shape regardless of the specific nature of various ureteral diseases. We tested renovated DJS and compared them with conventional DJS using ureter models. METHODS One straight ureter model included stenosis at the distal ureter near the ureterovesical junction and the other did not. We used conventional DJS and renovated 5- and 6-Fr soft DJS for ureter stones and 6-, 7-, and 8.5-Fr hard DJS for tumors. The DJS comprised holes in the upper, middle, or lower one-third of the shaft (length, 24 cm; 2-cm-diameter coils at both ends). More holes were created along the shaft based on the ureteral disease location. Conventional DJS had holes spaced 1 cm apart along the shaft. Renovated DJS had holes spaced 1 cm apart along the shaft with 0.5-cm intervals on the upper, middle, or lower one-third of the shaft. Urine flow was evaluated. RESULTS As the DJS diameter increased, the flow rate decreased. The flow rates of DJS with holes in the lower shaft were relatively lower than those of conventional DJS and DJS with holes in the upper and middle shafts. In the ureter model without stenosis, 6-, 7-, and 8.5-Fr renovated stents exhibited significantly higher flow rates than conventional stents. In the ureter model with stenosis, 5-, 6-, 7-, and 8.5-Fr renovated stents did not exhibit significantly higher flow rates than conventional stents. CONCLUSION Renovated stents and conventional stents did not exhibit significant differences in urine flow with stenosis.
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Affiliation(s)
- Young-Ho Choi
- Department of Radiology, College of Medicine, Seoul Nat'l Univ, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - Hyo Jeong Kang
- School of Mechanical and Material Convergence Engineering, Gyeongsang National University, Jinju, Republic of Korea
| | - Kyung-Wuk Kim
- Department of Mechanical Engineering, Soongsil University, Seoul, Republic of Korea
| | - Mun Seong Jo
- School of Mechanical and Material Convergence Engineering, Gyeongsang National University, Jinju, Republic of Korea
| | - Md Didarul Islam
- School of Mechanical and Material Convergence Engineering, Gyeongsang National University, Jinju, Republic of Korea
| | - Jeong Sik Kim
- School of Mechanical and Material Convergence Engineering, Gyeongsang National University, Jinju, Republic of Korea
| | - Sang Jin Jeon
- School of Mechanical and Material Convergence Engineering, Gyeongsang National University, Jinju, Republic of Korea
| | - Changje Lee
- Research Institute of Maritime Industry, Korea Maritime & Ocean University, Busan, Republic of Korea
| | - Seung Bae Lee
- Department of Urology, Sheikh Khalifa Specialty Hospital, Ras al Khaimah, United Arab Emirates
| | - Min Uk Kim
- Department of Radiology, College of Medicine, Seoul Nat'l Univ, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - Hyoung-Ho Kim
- School of Mechanical and Material Convergence Engineering, Gyeongsang National University, Jinju, Republic of Korea.
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Awonusi BO, Li H, Yin Z, Zhao J, Yang K, Li J. Surface Modification of Zn-Cu Alloy with Heparin Nanoparticles for Urinary Implant Applications. ACS APPLIED BIO MATERIALS 2024; 7:1748-1762. [PMID: 38428026 DOI: 10.1021/acsabm.3c01177] [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] [Indexed: 03/03/2024]
Abstract
In this work, an investigation on the Zn-Cu alloy coated with heparin was conducted in order to explore the potentiality of its application as a feasible alternative for biodegradable implants, with the specific goal of addressing the issue of encrustation in the urinary system. The stability of the nanoparticles were characterized by dynamic light scattering. Typical surface characterization such as X-ray photoelectron spectroscopy, scanning electron microscopy, and atomic force microscopy were used to demonstrate a successful immobilization of the NPs. The in vitro corrosion behavior was studied by potentiodynamic polarization and immersion tests in artificial urine (AU) at 37 °C. The 8 weeks in vivo degradation, encrustation resistance, hemocompatibility, and histocompatibility were investigated by means of implantation into the bladders of rats. Both in vitro and in vivo degradation tests exhibited a higher degradation rate for Zn-Cu and NPs groups when compared to pure Zn. Histological evaluations and hemocompatibility revealed that there was no tissue damage or pathological alterations caused by the degradation process. Furthermore, antiencrustation performance and urinalysis results confirmed that the modified alloy demonstrated significant encrustation inhibitory properties and bactericidal activity compared to the pure Zn control. Our findings highlight the potential of this modified alloy as an antiencrustation biodegradable ureteral stent.
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Affiliation(s)
- Bukola O Awonusi
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
| | - Hongwei Li
- Department of Urology, General Hospital of Northern Theater Command, Shenyang 110840, China
| | - Zecheng Yin
- Institute of Information and Control Engineering, Shenyang Urban Construction University, Shenyang 110167, China
| | - Jing Zhao
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
| | - Ke Yang
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
| | - Jianzhong Li
- Department of Urology, General Hospital of Northern Theater Command, Shenyang 110840, China
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Finegersh A, Chang J, Lee YJ, Sirjani D. Suture Stenting After Sialendoscopy: A Novel Technique That Reduces Risk of Recurrent Parotitis. Laryngoscope 2024; 134:614-621. [PMID: 37338090 DOI: 10.1002/lary.30828] [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: 11/23/2022] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVE Chronic sialadenitis is associated with decreased quality of life and recurrent infections. While sialendoscopy with stenting is effective in relieving symptoms of sialadenitis, currently available stents are rigid and poorly tolerated by patients, leading to early removal and potential for adverse scarring. This study examines whether sutures can be used as a stenting material to improve patient comfort and reduce recurrence risk. METHODS This is a retrospective cohort study of a consecutive series of adult patients with chronic sialadenitis undergoing sialendoscopy with or without suture stenting. Data were collected between 2014 and 2018 with a 3-year follow-up period ending in 2021. The primary outcome measure was recurrence of sialadenitis within 3 years of surgery. Secondary outcomes were stent dislodgement and patient-reported discomfort. RESULTS We included 63 patients with parotid sialadenitis of whom 28 underwent suture stenting and 35 did not receive stenting after sialendoscopy. Stents were well tolerated, with a mean duration of 34.5 days, and only 2 of 28 stents (7.1%) accidentally dislodged within the first week. Suture stenting significantly reduced symptom recurrence after sialendoscopy (OR = 0.09, 95% CI 0.02-0.45, p = 0.003; 3-year sialadenitis recurrence rate: 7.1% vs. 45.7%, p = 0.005). Cox multivariate regression for clinicodemographic variables showed an HR of 0.04 (95% CI 0.01-0.19, p < 0.001) for the risk of symptom recurrence. CONCLUSIONS AND RELEVANCE Suture stenting after sialendoscopy is low cost, available across all institutions, well-tolerated by patients, and highly efficacious in reducing risk of recurrent sialadenitis after sialendoscopy. LEVEL OF EVIDENCE 3 Laryngoscope, 134:614-621, 2024.
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Affiliation(s)
- Andrey Finegersh
- Division of Head and Neck Surgery, Department of Otolaryngology, Stanford University, Palo Alto, California, USA
- Department of Otolaryngology, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Julia Chang
- Division of Head and Neck Surgery, Department of Otolaryngology, Stanford University, Palo Alto, California, USA
- Department of Otolaryngology, Loma Linda University, Loma Linda, California, USA
| | - Yu-Jin Lee
- Division of Head and Neck Surgery, Department of Otolaryngology, Stanford University, Palo Alto, California, USA
| | - Davud Sirjani
- Division of Head and Neck Surgery, Department of Otolaryngology, Stanford University, Palo Alto, California, USA
- Department of Otolaryngology, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
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Tang H, Wu D, Liu Z, Liu X, Yuan H, Jin X, Gao S, Chen G. Polyvinylpyrrolidone hydrogel coating for ureteral stent: Safety and performance evaluation. Biomed Mater Eng 2024; 35:205-217. [PMID: 38277278 DOI: 10.3233/bme-230179] [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] [Indexed: 01/28/2024]
Abstract
BACKGROUND Ureteral stents are commonly used in urology. However, complications such as encrustation and infection on the surface of the stent, and injury to the ureteral mucosa can occur after implantation, causing discomfort for patients. OBJECTIVE We intend to confirm the biosafety of polyvinylpyrrolidone (PVP) hydrophilic coating and its lubrication properties for surface modification of ureteral stents to reduce friction and improve patient comfort. METHODS Based on our previous studies, we have developed a PVP hydrophilic coating for surface modification of ureteral stents. We firstly investigated the cytotoxicity, intradermal irritation, delayed type hypersensitivity, and acute systemic reactions of stent coating extracts. We further characterized the break strength, retention strength, and dynamic friction of the stent. RESULTS The cell survival rate of all experimental groups was greater than 70%. No hypersensitivity reaction, systemic toxicity reaction, or obvious intradermal reaction were observed. The above results indicate that the test results of the modified stent meet the requirements of ISO 10993-5: 2009 (Cytotoxicity); ISO 10993-10:2021 (Sensitization and Irritation); ISO 10993-11:2017 (Acute Systemic Toxicity). After soaking in artificial urine for an extended period, there was no obvious change in its super-slip performance. CONCLUSION Our results confirm the safety and lubrication characteristics of PVP hydrophilic coating for ureteral stent surface modification. The performance of this coating has the potential to reduce complications after stent implantation, thereby improving patient comfort, reducing medical burden, and has a good clinical application prospect.
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Affiliation(s)
- Haibin Tang
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dimeng Wu
- Chengdu Daxan Innovative Medical Tech. Co., Ltd., Chengdu, China
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China
| | - Zheng Liu
- Chengdu Daxan Innovative Medical Tech. Co., Ltd., Chengdu, China
| | - Xi Liu
- College of Biomass Science and Engineering, Sichuan University, Chengdu, China
| | - Heng Yuan
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaosong Jin
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shuai Gao
- Chengdu Daxan Innovative Medical Tech. Co., Ltd., Chengdu, China
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China
| | - Gang Chen
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Duan L, Wang Z, Fan S, Wang C, Zhang Y. Research progress of biomaterials and innovative technologies in urinary tissue engineering. Front Bioeng Biotechnol 2023; 11:1258666. [PMID: 37645598 PMCID: PMC10461011 DOI: 10.3389/fbioe.2023.1258666] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 08/02/2023] [Indexed: 08/31/2023] Open
Abstract
Substantial interests have been attracted to multiple bioactive and biomimetic biomaterials in recent decades because of their ability in presenting a structural and functional reconstruction of urinary tissues. Some innovative technologies have also been surging in urinary tissue engineering and urological regeneration by providing insights into the physiological behavior of the urinary system. As such, the hierarchical structure and tissue function of the bladder, urethra, and ureter can be reproduced similarly to the native urinary tissues. This review aims to summarize recent advances in functional biomaterials and biomimetic technologies toward urological reconstruction. Various nanofirous biomaterials derived from decellularized natural tissues, synthetic biopolymers, and hybrid scaffolds were developed with desired microstructure, surface chemistry, and mechanical properties. Some growth factors, drugs, as well as inorganic nanomaterials were also utilized to enhance the biological activity and functionality of scaffolds. Notably, it is emphasized that advanced approaches, such as 3D (bio) printing and organoids, have also been developed to facilitate structural and functional regeneration of the urological system. So in this review, we discussed the fabrication strategies, physiochemical properties, and biofunctional modification of regenerative biomaterials and their potential clinical application of fast-evolving technologies. In addition, future prospective and commercial products are further proposed and discussed.
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Affiliation(s)
- Liwei Duan
- The Second Hospital, Jilin University, Changchun, China
| | - Zongliang Wang
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, China
| | - Shuang Fan
- The Second Hospital, Jilin University, Changchun, China
| | - Chen Wang
- The Second Hospital, Jilin University, Changchun, China
| | - Yi Zhang
- The Second Hospital, Jilin University, Changchun, China
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Wang HJ, Hao MF, Wang G, Peng H, Wahid F, Yang Y, Liang L, Liu SQ, Li RL, Feng SY. Zein nanospheres assisting inorganic and organic drug combination to overcome stent implantation-induced thrombosis and infection. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 873:162438. [PMID: 36842591 DOI: 10.1016/j.scitotenv.2023.162438] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/11/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
The complication of stent implantation is the biggest obstacle to the success of its clinical application. In this study, we developed a combination way of 3D printing and the coating technique for preparation of functional polyurethane stents against stent implantation-induced thrombosis and postoperative infection. SEM, XPS, static water contact angle, and XRD demonstrated that the functional polyurethane stent had a 37 μm-thickness membrane composed of zein nanospheres (250-350 nm). Meanwhile, ZnO nanoparticles were encapsulated in zein nanospheres while heparin was adsorbed on the surface, causing 97.1 ± 6.4 % release of heparin in 120 min (first-order kinetic model) and 62.7 ± 5.6 % release of Zn2+ in 9 days (Korsmeyer-Peppas model). The mechanical analysis revealed that the functional polyurethane stents had about 8.61 MPa and 2.5 MPa tensile strength and bending strength, respectively. The in vitro biological analysis showed that the functional polyurethane stents had good EA.hy926 cells compatibility (97.9 ± 3.8 %), anti-coagulation response (comparable plasma protein, platelet adhesion and suppressed clotting) and sustained antibacterial activities by comparison with the bare polyurethane stent. The preliminary evaluation by rabbit ex vivo carotid artery intervention experiment demonstrated that the functional polyurethane stents could maintain blood circulation under the continuous stresses of blood flow. Meanwhile, the detailed data from the simulated implant infection experiment in vivo showed the functional polyurethane stents could effectively reduce microbial infection by 3-6 times lower and improve fibrosis and macrophage infiltration.
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Affiliation(s)
- Hua-Jie Wang
- Xinxiang Key Laboratory of 3D Bioprinting and Precision Medicine, School of Chemistry and Chemical Engineering, Henan Institute of Science and Technology, Eastern HuaLan Avenue, Xinxiang, Henan 453003, PR China; School of Food Science, Henan Institute of Science and Technology, Eastern HuaLan Avenue, Xinxiang, Henan 453003, PR China.
| | - Meng-Fei Hao
- Xinxiang Key Laboratory of 3D Bioprinting and Precision Medicine, School of Chemistry and Chemical Engineering, Henan Institute of Science and Technology, Eastern HuaLan Avenue, Xinxiang, Henan 453003, PR China
| | - Guan Wang
- Xinxiang Key Laboratory of 3D Bioprinting and Precision Medicine, School of Chemistry and Chemical Engineering, Henan Institute of Science and Technology, Eastern HuaLan Avenue, Xinxiang, Henan 453003, PR China
| | - Hao Peng
- Xinxiang Key Laboratory of 3D Bioprinting and Precision Medicine, School of Chemistry and Chemical Engineering, Henan Institute of Science and Technology, Eastern HuaLan Avenue, Xinxiang, Henan 453003, PR China
| | - Fazli Wahid
- School of Biomedical Sciences and Biotechnology, Pak-Austria Fachhochshule: Institute of Applied Sciences and Technology, Mang, Khanpur Road, Haripur 22620, Pakistan
| | - Yan Yang
- Xinxiang Key Laboratory of 3D Bioprinting and Precision Medicine, School of Chemistry and Chemical Engineering, Henan Institute of Science and Technology, Eastern HuaLan Avenue, Xinxiang, Henan 453003, PR China
| | - Lei Liang
- Xinxiang Key Laboratory of 3D Bioprinting and Precision Medicine, School of Chemistry and Chemical Engineering, Henan Institute of Science and Technology, Eastern HuaLan Avenue, Xinxiang, Henan 453003, PR China
| | - Shan-Qin Liu
- Xinxiang Key Laboratory of 3D Bioprinting and Precision Medicine, School of Chemistry and Chemical Engineering, Henan Institute of Science and Technology, Eastern HuaLan Avenue, Xinxiang, Henan 453003, PR China
| | - Ren-Long Li
- Xinxiang Key Laboratory of 3D Bioprinting and Precision Medicine, School of Chemistry and Chemical Engineering, Henan Institute of Science and Technology, Eastern HuaLan Avenue, Xinxiang, Henan 453003, PR China
| | - Shu-Ying Feng
- Medical College, Henan University of Chinese Medicine, No. 156, Jinshui East Road, Zhengzhou, Henan 450046, PR China
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Baker Berjaoui M, Li T, Lawson K, Kogon M. Case - An invisible stent. Can Urol Assoc J 2023; 17:E100-E102. [PMID: 36473476 PMCID: PMC10027357 DOI: 10.5489/cuaj.8024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A 72-year-old male presented for an annual left-sided ureteral stent change. The stent was entirely invisible on fluoroscopy, but interestingly, was completely intact and functioning normally. After cystoscopic retrieval, ex-vivo fluoroscopy demonstrated that this stent was more radiolucent compared to a brand-new stent. A review of serial computed tomography (CT) imaging demonstrated progressive loss of radio-opacity of the stent over time. We theorize that the stent lost its radio-opaque coating due to chronic exposure to urine, suggesting a need for more resilient stent coatings to avoid complications such as forgotten stent syndrome.
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Affiliation(s)
| | - Tiange Li
- Division of Urology, University of Toronto, Toronto, ON, Canada
| | - Keith Lawson
- Division of Urology, University of Toronto, Toronto, ON, Canada
| | - Michael Kogon
- Division of Urology, Mackenzie Health, Vaughan, ON, Canada
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Bhardwaj M, Ingole N. Application, Advancement, and Complication of Ureteral Stent and Encrustation: A Major Complication. Cureus 2022; 14:e28639. [PMID: 36196322 PMCID: PMC9524851 DOI: 10.7759/cureus.28639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 08/31/2022] [Indexed: 11/28/2022] Open
Abstract
Three technological aspects have a significant impact on the functioning of an optimal stent. The substance it is made up of, model or design, and coating of the surface are important areas for research. To give recognition of an ideal stent, it summarizes some essential breakthroughs that occurred. Encrustation is a regular problem that can happen when a ureteral stent is implanted in the urinary tract, and it may be dangerous. The part of the paper covers the mechanism of encrustation, stent management, and the most recent technologies created to solve this problem. Encrustation has a complicated and diverse mechanism that includes the time it stays inside, patient-specific risk factors, controlled film production, formation of biofilm, and deposition of minerals. A number of high-tech advancements in stent substances and coverings/coatings could help to reduce the danger of encrustation of stents. It's critical to determine the amount of encrustation of a stent so that therapy options can be tailored properly. For the care of ureteral stents, which are encrusted, we offer a unique therapeutic protocol. The duration of stent indwelling time has been repeatedly established to be a critical risk factor for the evolution of encrustation. The period of stent indwelling time has consistently been established to be a critical risk element for the evolution of encrustation. Patients who are predisposed to bacteriuria and urinary lithiasis are also predisposed to encrustation. Repeated urinary tract infections, diabetes, and chronic kidney failure are among the factors that might escalate urine bacterial load, which can lead to stent encrustation. Due to the prevalence of ureteral stents in urology, it's critical to keep up to date on the best ways to prevent stent encrustation, recognize high-risk patients, and remove them using multimodal techniques.
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Tang C, Qu G, Yang G, Wang G, Xu Y. Case Report: A Calculus-Free Ureteral Stent Forgotten for 29 Years. Front Surg 2022; 9:878660. [PMID: 35574532 PMCID: PMC9098992 DOI: 10.3389/fsurg.2022.878660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
Ureteral stents are widely used. If ureteral stents remain in place for extended periods, the probability of migration and stone formation increases substantially. However, a 29-year-old ureteral stent that was placed and did not develop calculus is rare. We reported a 45-year-old man admitted with pain in the left side of his waist and abdomen for more than 10 years. He underwent a ureterotomy 29 years prior to admission for left ureteral calculi, and a ureteral stent was placed postoperatively to prevent ureteral strictures. The ureteral stent was not removed in the hospital due to poor compliance on the part of the patient. This left ureteral stent was not visible on computed tomography (CT) and plain films. On ureteroscopy or flexible ureteroscopy, no new calculus was found in the left ureter and kidney. No calculus was found in the stent that is usually easily removed with calculus-removing forceps. This phenomenon is rare, and it highlights the importance of follow-up.
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Affiliation(s)
- Cheng Tang
- Department of Urology, The Affiliated Zhuzhou Hospital of Xiangya Medical College, Central South University, Zhuzhou, China
| | - Genyi Qu
- Department of Urology, The Affiliated Zhuzhou Hospital of Xiangya Medical College, Central South University, Zhuzhou, China
| | - Guang Yang
- Department of Urology, The Affiliated Zhuzhou Hospital of Xiangya Medical College, Central South University, Zhuzhou, China
| | - Gang Wang
- Department of Rheumatology and Immunology, The Affiliated Zhuzhou Hospital of Xiangya Medical College, Central South University, Zhuzhou, China
| | - Yong Xu
- Department of Urology, The Affiliated Zhuzhou Hospital of Xiangya Medical College, Central South University, Zhuzhou, China
- *Correspondence: Yong Xu
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