Role of ureteral stent material and coating to prevent ureteral stent related issue: A systematic review and meta analysis

Published: March 4, 2024
Abstract Views: 653
PDF: 312
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Introduction: Ureteral stents require materials that balance bulk and surface properties. Achieving both can be challenging, as ideal bulk properties may not align with optimal surface properties. Thus, researching coatings and biomanufacturing methods for ideal materials is essential.
Methods: A systematic review and meta-analysis, following PRISMA Guidelines, involved literature searches across five databases: PubMed, Scopus, Embase, ClinicalKey, and Cochrane. From 417 screened articles, eight studies were deemed eligible for qualitative and quantitative analysis. The selected articles underwent bias assessment using ROB Tools 2.
Results: The systematic review analyzed 1.356 participants. Findings revealed that firm ureteral stents significantly increased risk of infection, hematuria, and lower body pain. On the contrary, soft stents reduced infection (OR: 0.62; p=0.004), hematuria (OR: 0.60; p<0.001), and lower body pain (OR: 0.63; p=0.0002). However, infection reduction effect was uncertain due to heterogeneity. Coated vs non-coated material analysis found no difference in encrustation (OR: 1.26; p=0.52) or infection (OR: 1.67; p=0.99). Stent firmness did not affect encrustation on double J stent (OR: 0.97; p=0.17).
Conclusions: Softer materials like silicone are preferred for ureteral stents to reduce symptoms like hematuria and lower body pain. Coatings like silver nanoparticles and triclosan, while enhancing antimicrobial properties, did not effectively lower infection risk.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Geavlete P, Georgescu D, Multescu R, et al. Ureteral stent complications- experience on 50,000 procedures. J Med Life. 2021;14:769-775. DOI: https://doi.org/10.25122/jml-2021-0352
Yin IX, Zhang J, Zhao IS, et al. The Antibacterial Mechanism of Silver Nanoparticles and Its Application in Dentistry. In J Nanomedicine. 2020; 15:2555-2562. DOI: https://doi.org/10.2147/IJN.S246764
Nudera WJ, Fayad MI, Johnson BR, et al. Antimicrobial effect of triclosan and triclosan with Gantrez on five common endodontic pathogens. J Endod. 2007; 33:1239-42. DOI: https://doi.org/10.1016/j.joen.2007.06.009
Yang L, Whiteside S, Cadieux PA, Denstedt JD. Ureteral stent technology: Drug-eluting stents and stent coatings. Asian J Urol. 2015; 2:194-201. DOI: https://doi.org/10.1016/j.ajur.2015.08.006
El-Nahas AR, El-Assmy AM, Shoma AM, et al. Self-retaining ureteral stents: analysis of factors responsible for patients' discomfort. J Endourol. 2006; 20:33-7. DOI: https://doi.org/10.1089/end.2006.20.33
Cadieux PA, Chew BH, Nott L, et al. Use of triclosan-eluting ureteral stents in patients with long-term stents. J Endourol. 2009; 23:1187-94. DOI: https://doi.org/10.1089/end.2008.0437
El-Nahas AR, Lachine M, Elsawy E, et al. A randomized controlled trial comparing antimicrobial (silver sulfadiazine) coated ureteral stents with non-coated stents. Scand J Urol. 2018; 52:76-80. DOI: https://doi.org/10.1080/21681805.2017.1376353
Gadzhiev N, Gorelov D, Malkhasyan V, et al. Comparison of silicone versus polyurethane ureteral stents: a prospective controlled study. BMC Urol. 2020; 20:10. DOI: https://doi.org/10.1186/s12894-020-0577-y
Joshi HB, Chitale SV, Nagarajan M, et al. A prospective randomized single-blind comparison of ureteral stents composed of firm and soft polymer. J Urol. 2005; 174:2303-6. DOI: https://doi.org/10.1097/01.ju.0000181815.63998.5f
Lennon GM, Thornhill JA, Sweeney PA, et al. 'Firm' versus 'soft' double pigtail ureteric stents: a randomised blind comparative trial. Eur Urol. 1995; 28:1-5. DOI: https://doi.org/10.1159/000475010
Mendez-Probst CE, Goneau LW, MacDonald KW, et al. The use of triclosan eluting stents effectively reduces ureteral stent symptoms: a prospective randomized trial. BJU Int. 2012; 110:749-54. DOI: https://doi.org/10.1111/j.1464-410X.2011.10903.x
Scarneciu I, Lupu S, Pricop C, Scarneciu C. Morbidity and impact on quality of life in patients with indwelling ureteral stents: A 10-year clinical experience. Pak J Med Sci. 2015; 31:522-6. DOI: https://doi.org/10.12669/pjms.313.6759
Boeykens M, Keller EX, Bosio A, et al. Impact of Ureteral Stent Material on Stent-related Symptoms: A Systematic Review of the Literature. Eur Urol Open Sci. 2022; 45:108-117. DOI: https://doi.org/10.1016/j.euros.2022.09.005
Al-Aown A, Kyriazis I, Kallidonis P, et al. Ureteral stents: new ideas, new designs. Ther Adv Urol. 2010; 2:85-92. DOI: https://doi.org/10.1177/1756287210370699
Bruna T, Maldonado-Bravo F, Jara P, Caro N. Silver Nanoparticles and Their Antibacterial Applications. Int J Mol Sci. 2021; 22:7202. DOI: https://doi.org/10.3390/ijms22137202
Alfhili MA, Lee MH. Triclosan: An Update on Biochemical and Molecular Mechanisms. Oxid Med Cell Longev. 2019; 2019:1607304. DOI: https://doi.org/10.1155/2019/1607304
Modaresifar K, Azizian S, Ganjian M, et al. Bactericidal effects of nanopatterns: A systematic review. Acta Biomater. 2019; 83:29-36. DOI: https://doi.org/10.1016/j.actbio.2018.09.059

How to Cite

Putrantyo, I. I., Warli, S. M., Siregar, G. P., Prapiska, F. F., Kadar, D. D., & Sihombing, B. (2024). Role of ureteral stent material and coating to prevent ureteral stent related issue: A systematic review and meta analysis. Archivio Italiano Di Urologia E Andrologia, 96(1). https://doi.org/10.4081/aiua.2024.12067