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Wu Y, Liu S, Fan Y, Li J, Deng Y, Yu P, Ning C, Zhai J. Advanced multifunctional coatings in ureteral stents: Interfacial design, properties, and applications. Adv Colloid Interface Sci 2025; 343:103542. [PMID: 40367554 DOI: 10.1016/j.cis.2025.103542] [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: 07/02/2024] [Revised: 04/08/2025] [Accepted: 05/05/2025] [Indexed: 05/16/2025]
Abstract
Ureteral stents play an essential role in the clinical practice of managing both benign and malignant urinary tract disorders. However, their use is accompanied by various complications, including tissue damage, urinary tract infection, biofilm formation, and encrustation. Although ureteral stents demonstrate remarkable efficacy in alleviating urinary tract obstruction, the multifaceted complications stemming from the demanding physiological environment of the urinary system continue to present a formidable challenge to clinical management. Therefore, the strategies to develop multifunctional stents are critical to address the complex microenvironment of long-term indwelling urinary tract. This review initially examines the challenges associated with the urinary tract interface environment and outlines strategies to overcome them. It then highlights the state-of-the-art advances in multifunctional urinary stents and discusses customized solutions that meet clinical practice depending on the duration of stent indwelling. Finally, we discuss the potential for designing smart-responsive multifunctional coating technologies, designed for precision therapy. This review provides insight into the development of advanced ureteral stents.
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Affiliation(s)
- Yucong Wu
- School of Materials Science and Engineering, South China University of Technology, Guangzhou 510006, PR China; National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, PR China
| | - Senwei Liu
- School of Materials Science and Engineering, South China University of Technology, Guangzhou 510006, PR China; National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, PR China
| | - Youzhun Fan
- School of Materials Science and Engineering, South China University of Technology, Guangzhou 510006, PR China; National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, PR China
| | - Jiawei Li
- School of Materials Science and Engineering, South China University of Technology, Guangzhou 510006, PR China; National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, PR China
| | - Yingshan Deng
- School of Life Sciences, South China Normal University, Guangzhou 510631, PR China
| | - Peng Yu
- School of Materials Science and Engineering, South China University of Technology, Guangzhou 510006, PR China; National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, PR China.
| | - Chengyun Ning
- School of Materials Science and Engineering, South China University of Technology, Guangzhou 510006, PR China; National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, PR China.
| | - Jinxia Zhai
- School of Materials Science and Engineering, South China University of Technology, Guangzhou 510006, PR China; National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou 510006, PR China; College of Medical Instruments, Guangdong Food and Drug Vocational College, Guangzhou 510520, PR China.
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Castellani D, Somani BK, Fong KY, Yuen SKK, Heng CT, Elshazly M, Tan K, Herrmann TRW, Traxer O, Gauhar V. Can flexible ureteroscopy using flexible and navigable suction ureteral access sheath (FANS-UAS) minimize postoperative double J stent placement? Results from a propensity score-matched analysis of 540 patients of the European Association of Urology Section of Endourology and global FANS collaborative study group. Investig Clin Urol 2025; 66:236-244. [PMID: 40312903 PMCID: PMC12058539 DOI: 10.4111/icu.20250071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2025] [Revised: 03/04/2025] [Accepted: 03/09/2025] [Indexed: 05/03/2025] Open
Abstract
PURPOSE To evaluate whether using flexible and navigable suction ureteral access sheath can obviate insertion of double J stent and establish the safety of overnight ureteric catheter placement as alternative following flexible ureteroscopy for kidney stones. MATERIALS AND METHODS Five hundred forty adults were prospectively enrolled across 25 centers (from April 2023 to January 2024). Patients were divided into group 1 (overnight ureteric catheter), and group 2 (double J stent). Surgeons could choose either modality as per their discretion. One-to-one propensity score-matching for age, sex, pre-stenting, Hounsfield units, stone volume and location was performed. Thirty-day computed tomography scan was done to estimate stone-free status. RESULTS After matching, 120 patients were included in each group. Group 1 had significantly shorter lasing, ureteroscopy, surgical time. Median day 1 loin pain score was similar (1 [1, 2] in both groups). Median postoperative stay was shorter in group 1 (0 days [0, 1] vs. 1 day [0, 2], p<0.001). One patient in group 2 required a blood transfusion. Incidence of fever was similar (5.0% vs. 0.8%). Loin/abdominal pain requiring medication occurred in one patient in group 2. Stent-related symptoms occurred in 2 patients in group 1. Three patients (2.5%) in group 1 and 2 patients (1.7%) in group 2 required readmission. Thirty-day stone-free status was higher in group 1 patients (79.2% vs. 56.7%). CONCLUSIONS In selected patients after thorough inspection to ensure no injury or residual fragments remain, placing an overnight ureteric catheter can be a safe alternative to a double J stent.
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Affiliation(s)
- Daniele Castellani
- Urology Unit, Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy
- European Association of Urology Section of Endourology, Arnhem, The Netherlands.
| | - Bhaskar Kumar Somani
- European Association of Urology Section of Endourology, Arnhem, The Netherlands
- Department of Urology, University Hospitals Southampton, NHS Trust, Southampton, UK
| | - Khi Yung Fong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Steffi Kar Kei Yuen
- European Association of Urology Section of Endourology, Arnhem, The Netherlands
- SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - Chin Tiong Heng
- Department of Urology, Ng Teng Fong General Hospital, Singapore
| | | | - Karl Tan
- Department of Surgery, Section of Urology, Veterans Memorial Medical Center, Quezon City, Philippines
| | - Thomas R W Herrmann
- European Association of Urology Section of Endourology, Arnhem, The Netherlands
- Spital Thurgau AG (STGAG), Frauenfeld, Switzerland
| | - Olivier Traxer
- European Association of Urology Section of Endourology, Arnhem, The Netherlands
- Department of Urology, Tenon Hospital, AP-HP Sorbonne University, Paris, France
| | - Vineet Gauhar
- European Association of Urology Section of Endourology, Arnhem, The Netherlands
- Department of Urology, Ng Teng Fong General Hospital, Singapore
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Toraman MM, Gürçayır D. The effect of training given to patients who underwent ureteroscopy with double-J stent placement on anxiety before and after surgery and readiness for discharge. Urolithiasis 2024; 53:9. [PMID: 39680153 DOI: 10.1007/s00240-024-01654-4] [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: 07/06/2024] [Accepted: 10/21/2024] [Indexed: 12/17/2024]
Abstract
Patient education is effective in reducing the level of anxiety before and after surgery and increasing the level of readiness for discharge. Patient education provided by nurses can be planned and applied individually. Therefore, this study aims to determine the effect of the education in whom a double J stent after ureteroscopy on their pre- and postoperative anxiety and levels of readiness for discharge. This research study is a randomized controlled trial with control and intervention groups, pre- and posttests. This study was conducted between November 2021 and May 2022 in a university hospital in Turkey. The patients were divided at random into two groups, control (n = 61) and intervention (n = 61). The Personal Information Form, State-Trait Anxiety Inventory (STAI-I, STAI-II), Surgery-Specific Anxiety Scale (SSAS), Readiness for Hospital Discharge Scale for Adult Patients-Short Form (RHDS/SF) and Readiness for Hospital Discharge Scale- Adult-Nurse Assesment Short Form (RN-RHDS/SF) were used to collect the data. The mean SSAS and STAI-I scores on the morning of surgery and before discharge were found to be significantly lower in the intervention group than the control group. The mean RHDS/SF and RN-RHDS/SF scores on the before discharge were found to be significantly higher in the intervention group than the control group. It was concluded that the education provided to the patients in whom a double J stent after ureteroscopy reduced pre- and postoperative anxiety and increased the level of readiness for discharge.
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Affiliation(s)
| | - Dilek Gürçayır
- Faculty of Nursing, Atatürk University, Erzurum, Turkey.
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Tabares Jiménez J, Bueno Serrano G, Alcoba García MP, González López R, Gómez Jordana B, Mahillo Fernández I, González Enguita C. Assessment of changes in sexual function in patients undergoing endoscopic surgery for upper urinary tract lithiasis. Actas Urol Esp 2024; 48:688-694. [PMID: 39313025 DOI: 10.1016/j.acuroe.2024.09.003] [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: 04/28/2024] [Accepted: 06/25/2024] [Indexed: 09/25/2024]
Abstract
OBJECTIVE To evaluate the effect of endoscopic surgery on sexual function in patients with upper urinary tract (UUT) lithiasis. MATERIAL AND METHODS We conducted an observational, prospective, longitudinal study with a single cohort of cases undergoing ureteroscopy (URS), retrograde intrarenal surgery (RIRS), or endoscopic combined intrarenal surgery (ECIRS). Patients' sexual response was assessed with questionnaires in the 30 days prior to surgery, and at one and three months after surgery. The International Index of Erectile Function (IIEF-t) was used in male patients, and the Female Sexual Function Index (FSFI) was used in female patients. RESULTS Seventy patients - 34 men and 36 women - completed the study. Among men, the IIEF-t did not show significant difference between baseline scores (64.1 ± 7.50) and those obtained at 3 months (63.8 ± 9.51), with a non-significant decrease (p = 0.054) at the first month (61.4 ± 10.4). Subdomains did not worsen at 3 months, and desire (IIEF-SD) improved from 7.3 ± 1.9 to 8.0 ± 1.8. Among women, the FSFI-t did not change significantly after surgery: baseline score (27.3 ± 4.1), 1-month score (26.8 ± 3.7) and 3-month score (27.5 ± 4.2). No subdomain worsened at the third month. CONCLUSION Endoscopic surgery for UUT is a safe technique in both sexes with no negative effect on sexual function. There are no differences between the baseline IIEF-t and FSFI-t scores and those obtained at 3 months.
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Affiliation(s)
- J Tabares Jiménez
- Servicio de Urología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
| | - G Bueno Serrano
- Servicio de Urología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - M P Alcoba García
- Servicio de Urología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - R González López
- Servicio de Urología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - B Gómez Jordana
- Servicio de Urología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - I Mahillo Fernández
- Servicio de Urología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - C González Enguita
- Servicio de Urología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
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Qing J, Hu K, Zhang X, Luo H, Chen J, Li C, Zhang J. Allium covered metal stent for treatment of malignant ureteral obstruction. Front Surg 2024; 11:1445808. [PMID: 39628922 PMCID: PMC11611877 DOI: 10.3389/fsurg.2024.1445808] [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: 06/08/2024] [Accepted: 11/01/2024] [Indexed: 12/06/2024] Open
Abstract
Background Malignant ureteral obstruction (MUO) has the potential to result in a range of outcomes, including varying degrees of hydronephrosis and renal impairment. Allium covered metal stents have provided a new, highly effective treatment option for MUO. Our objective was to evaluate the safety and efficacy of the Allium covered metallic stent for the treatment of malignant ureteral obstruction. Methods Clinical data of 29 patients who underwent endoscopic insertion of an Allium ureteral stent between October 2019 and August 2021 at Yongchuan Hospital, affiliated with Chongqing Medical University, were analyzed retrospectively. At one, three, six and 12 months after insertion, serum creatinine was measured, the width of the renal pelvis was rechecked under ultrasound guidance, and the position and shape of the stent were checked by abdominal x-ray. Data on long-term stent patency, incidence of complications, changes in renal function and hydronephrosis grade were collected and analyzed. Ureteral stent symptom questionnaire (USSQ) was administered preoperatively and after six months in 22 patients with previous stent history. Results Allium covered metal stents (n = 33) were implanted successfully in 29 patients who were followed for three to 22 months, with 32/33 stents remaining patent. Serum creatinine levels decreased in 17 patients (p < 0.001), and hydronephrosis decreased in 24 patients. Clavien-Dindo grade I complications were observed in seven patients, Clavien-Dindo II in one patient, whereas stent displacement and stent encrustation occurred in one patient each (Clavien-Dindo III-IV). USSQ scores had significantly improved six months after stent insertion (p < 0.001). Conclusions Allium ureteral stents are a safe and effective treatment option for malignant ureteral obstruction, with good long-term patency, helping to preserve renal function and improve quality of life.
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Affiliation(s)
| | | | | | | | | | | | - Jiamo Zhang
- Department of Urology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China
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Bhat GS, Shastry A. Prospective randomized study to evaluate and compare the post-procedural sexual function in patients undergoing semi-rigid ureterorenoscopy for distal ureteric stones in three different operating room settings. Asian J Urol 2024; 11:331-338. [PMID: 38680574 PMCID: PMC11053307 DOI: 10.1016/j.ajur.2022.08.004] [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: 03/23/2022] [Accepted: 08/24/2022] [Indexed: 12/26/2022] Open
Abstract
Objective To evaluate and compare the effect of semi-rigid ureterorenoscopy on post-procedural sexual function with three different operating room settings. Methods In this prospective randomized study, consecutive sexually active patients with normal pre-operative sexual function undergoing uncomplicated semi-rigid ureterorenoscopy for distal ureteric stones were randomized into three groups, with three different operating room settings. Procedure-related anxiety and sexual function were assessed pre-operatively using Amsterdam Preoperative Anxiety and Information Scale and Brief Sexual Function Inventory (in males) and Female Sexual Function Index-6 (in females), respectively. All the participants were stented following the procedure, and the stent was removed after 3 weeks. Post-procedural sexual function and general discomfort were assessed and compared between three groups at 1 week, 3 weeks, and 12 weeks. The effect of surgery-related anxiety, preoperative sexual function, age, and general discomfort (including stent-related discomfort) on post-procedural sexual function were analyzed using multiple regression analysis. A p-value of less than 0.05 was considered statistically significant. Results Totally, 327 eligible patients were randomized into three groups. The group of patients who underwent the procedural with a screen separating the operating area from the patient vision, while the patient could watch the endoscopy through a separate monitor, had better post-procedural sexual function compared to those who had total vision of the operating area as well as to those whose eyes were blocked. This difference was statistically significant. This post-procedural reduction in sexual function could not be attributed to in situ stent alone. Conclusions Our study showed that semi-rigid ureterorenoscopy can have significant negative effect on sexual function, which can be reduced with proper preoperative counseling and an ideal operating room settings.
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Affiliation(s)
- Gajanan S. Bhat
- Sexual Medicine, TSS Shripad Hegde Kadave Institute of Medical Sciences, Sirsi, Karnataka, India
| | - Anuradha Shastry
- Department of Urology, Andrology and Sexual Medicine, TSS Shripad Hegde Kadave Institute of Medical Sciences, Sirsi, Karnataka, India
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Vo AK, Somani BK, Ulvik Ø, Beisland C, Seitz C, Juliebø-Jones P. Measuring quality of life in patients with kidney stone disease: is it the future in endourology? Curr Opin Urol 2024; 34:91-97. [PMID: 37889517 DOI: 10.1097/mou.0000000000001138] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
PURPOSE OF REVIEW Kidney stone disease is recognized to negatively impact quality of life. This pertains to acute episodes, surgical interventions and even during asymptomatic periods. Over time there has been increased attention towards assessing this subjective parameter, including as a determinant of treatment success. Our aim was to evaluate the current status and emerging trends in this field. RECENT FINDINGS Patient groups most affected appear to be recurrent stone formers, cystine stone formers, women, younger populations, non-Caucasians and low-income populations. Several stone specific patient reported outcome measures are now available of which, WISQol has been implemented the most in clinical research studies. More invasive interventions such as percutaneous nephrolithotomy impede quality of life to greater extent than alternatives such as shockwave lithotripsy. SUMMARY There are certain patient groups who are more vulnerable to the negative impact of kidney stone disease on their quality of life. Urologists can improve patient care by recognizing these particular populations as well as by implemented patient reported outcome measures in their routine clinical practice and when performing research.
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Affiliation(s)
- Anh Khoi Vo
- Department of Urology, Haukeland University Hospital, Bergen, Norway
| | | | - Øyvind Ulvik
- Department of Urology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Christian Beisland
- Department of Urology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Christian Seitz
- Department of Urology, Medical University of Vienna, Austria
| | - Patrick Juliebø-Jones
- Department of Urology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Mares C, Geavlete P, Georgescu D, Multescu R, Geavlete B. The Impact of the Double J Stent on Health and Sexual Life. MAEDICA 2023; 18:679-683. [PMID: 38348063 PMCID: PMC10859200 DOI: 10.26574/maedica.2023.18.4.679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Double J stents are commonplace tools used in modern urology, serving as a vital aid in the drainage of the upper urinary system. Along with the numerous advantages of these catheters, numerous negative consequences have also been addressed throughout time. Among the most common symptoms associated with ureteral catheters are those associated with LUTS (lower urinary tract symptoms), such as dysuria, urinary urgency, pollakiuria, the feeling of incomplete emptying of the bladder, urinary incontinence, or even urinary tract infections (UTIs). Complications associated with sexual dysfunction, including dyspareunia and pain during sex, which can lead to erectile dysfunction or loss of orgasm, are less discussed in the literature. This small review tries to focus on the most important aspects of low urinary symptoms that affect the general quality of life and those related to the quality of sexual life, which are less discussed but of particular importance in the lifestyle of any patient with such ureteral device.
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Affiliation(s)
- Cristian Mares
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- "Saint John" Emergency Clinical Hospital, Department of Urology, Bucharest, Romania
| | - Petrisor Geavlete
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- "Saint John" Emergency Clinical Hospital, Department of Urology, Bucharest, Romania
- Sanador Hospital, Bucharest, Romania
| | - Dragos Georgescu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- "Saint John" Emergency Clinical Hospital, Department of Urology, Bucharest, Romania
- Sanador Hospital, Bucharest, Romania
| | - Razvan Multescu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Sanador Hospital, Bucharest, Romania
| | - Bogdan Geavlete
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- "Saint John" Emergency Clinical Hospital, Department of Urology, Bucharest, Romania
- Sanador Hospital, Bucharest, Romania
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Chen X, Xia Y, Shen S, Wang C, Zan R, Yu H, Yang S, Zheng X, Yang J, Suo T, Gu Y, Zhang X. Research on the Current Application Status of Magnesium Metal Stents in Human Luminal Cavities. J Funct Biomater 2023; 14:462. [PMID: 37754876 PMCID: PMC10532415 DOI: 10.3390/jfb14090462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/01/2023] [Accepted: 09/06/2023] [Indexed: 09/28/2023] Open
Abstract
The human body comprises various tubular structures that have essential functions in different bodily systems. These structures are responsible for transporting food, liquids, waste, and other substances throughout the body. However, factors such as inflammation, tumors, stones, infections, or the accumulation of substances can lead to the narrowing or blockage of these tubular structures, which can impair the normal function of the corresponding organs or tissues. To address luminal obstructions, stenting is a commonly used treatment. However, to minimize complications associated with the long-term implantation of permanent stents, there is an increasing demand for biodegradable stents (BDS). Magnesium (Mg) metal is an exceptional choice for creating BDS due to its degradability, good mechanical properties, and biocompatibility. Currently, the Magmaris® coronary stents and UNITY-BTM biliary stent have obtained Conformité Européene (CE) certification. Moreover, there are several other types of stents undergoing research and development as well as clinical trials. In this review, we discuss the required degradation cycle and the specific properties (anti-inflammatory effect, antibacterial effect, etc.) of BDS in different lumen areas based on the biocompatibility and degradability of currently available magnesium-based scaffolds. We also offer potential insights into the future development of BDS.
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Affiliation(s)
- Xiang Chen
- School of Medicine, Anhui University of Science and Technology, Huainan 232000, China;
| | - Yan Xia
- School of Stomatology, Anhui Medical College, Hefei 230601, China;
| | - Sheng Shen
- Department of Biliary Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China; (S.S.); (R.Z.); (T.S.)
- Shanghai Engineering Research Center of Biliary Tract Minimal Invasive Surgery and Materials, Shanghai 200032, China;
| | - Chunyan Wang
- Shanghai Engineering Research Center of Biliary Tract Minimal Invasive Surgery and Materials, Shanghai 200032, China;
- Department of General Surgery, Shanghai Xuhui Central Hospital, Shanghai 200031, China
| | - Rui Zan
- Department of Biliary Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China; (S.S.); (R.Z.); (T.S.)
- Shanghai Engineering Research Center of Biliary Tract Minimal Invasive Surgery and Materials, Shanghai 200032, China;
| | - Han Yu
- State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China; (H.Y.); (S.Y.)
| | - Shi Yang
- State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China; (H.Y.); (S.Y.)
| | - Xiaohong Zheng
- Department of Hepatopancreatobiliary Surgery, Huainan Xinhua Hospital Affiliated to Anhui University of Science and Technology, Huainan 232000, China; (X.Z.); (J.Y.)
| | - Jiankang Yang
- Department of Hepatopancreatobiliary Surgery, Huainan Xinhua Hospital Affiliated to Anhui University of Science and Technology, Huainan 232000, China; (X.Z.); (J.Y.)
| | - Tao Suo
- Department of Biliary Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China; (S.S.); (R.Z.); (T.S.)
- Shanghai Engineering Research Center of Biliary Tract Minimal Invasive Surgery and Materials, Shanghai 200032, China;
| | - Yaqi Gu
- School of Medicine, Anhui University of Science and Technology, Huainan 232000, China;
- Department of Hepatopancreatobiliary Surgery, Huainan Xinhua Hospital Affiliated to Anhui University of Science and Technology, Huainan 232000, China; (X.Z.); (J.Y.)
| | - Xiaonong Zhang
- State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China; (H.Y.); (S.Y.)
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In vivo assessment of biodegradable magnesium alloy ureteral stents in a pig model. Acta Biomater 2020; 116:415-425. [PMID: 32949824 DOI: 10.1016/j.actbio.2020.09.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/05/2020] [Accepted: 09/10/2020] [Indexed: 01/08/2023]
Abstract
Today, ureteral stent technology is making progress towards the reduction of complications and patient discomfort. Therefore, magnesium alloys have become excellent candidate materials for manufacturing ureteral stents due to their biodegradability and antibacterial activity. Built on our previous work on biodegradable magnesium alloys, this article reports a semisolid rheo-formed magnesium implant that displays degradability and biocompatibility in vivo, and feasibility as ureteral stents in a pig model. Refined non-dendritic microstructure was observed in the rheo-formed alloy, whose grain size and shape factor were ca. 25.2 μm and ca. 1.56 respectively. Neither post-interventional inflammation nor pathological changes were observed in the urinary system during the implantation period of 14 weeks, and the degradation profile (14 weeks) meets the common requirement for the indwelling time of ureteral stents (8 to 16 weeks). Furthermore, histopathological observation and urinalysis results confirmed that the alloy had significantly higher antibacterial activity than the medical-grade stainless steel control. To our knowledge, this is the first in vivo study of biodegradable magnesium alloy as urinary implants in large animal models. Our results demonstrate that magnesium alloys may be a reasonable option for manufacturing biodegradable ureteral stents.
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Arora A, Sane MS, Jadhao V, Maheshwari PN. Sexual dysfunction in Indian men undergoing Double J ureteral stenting following ureteroscopy-A prospective analysis. Andrologia 2020; 52:e13790. [PMID: 32776564 DOI: 10.1111/and.13790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/25/2020] [Accepted: 07/12/2020] [Indexed: 12/29/2022] Open
Abstract
This prospective study was aimed to evaluate the impact of an indwelling ureteral double-J stent on the sexual health of Indian men undergoing ureteroscopy. The first phase of the study included 30 men who were not counselled prior to stenting about possible sexual dysfunction, while in the next phase, 60 men were counselled about this. These 60 patients were assessed by a 6-point questionnaire: five questions from the International Index of Erectile Function-5 (IIEF-5) and an additional 6th question to assess pain during erection/ejaculation. Patients answered the questionnaire prior to ureteroscopy, at the time of stent removal and then 4 weeks after stent removal. A higher proportion of men in the second phase attempted sexual activity (68.3% vs. 26.7%; p < .001). Significant changes were noted in the total IIEF-5 score (mean 23.16 before vs. 15.65 after, p < .001) and individual IIEF-5 components: erection confidence (4.59 vs. 2.76, p = .017), maintenance ability (4.67 vs. 2.43, p = .006) and intercourse satisfaction (4.61 vs. 2.31, p < .001) and also the 'pain' question (2.83 post-stenting vs. 0.37 pre-stenting, p < .001). Most patients had a recovery of scores at 4 weeks after stent removal. Thus, ureteral DJ stenting leads to significant but temporary sexual dysfunction and patients need to be counselled regarding this.
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Affiliation(s)
- Amandeep Arora
- Department of Urology, Fortis Hospital Mulund, Mumbai, India
| | - Mahesh S Sane
- Department of Urology, Fortis Hospital Mulund, Mumbai, India
| | - Vivek Jadhao
- Department of Urology, Fortis Hospital Mulund, Mumbai, India
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