Symptoms Associated With Long-term Double-J Ureteral Stenting and Influence of Biofilms

Betschart, Patrick; Zumstein, Valentin; Buhmann, Matthias T.; Altenried, Stefanie; Babst, Christa; Müllhaupt, Gautier; Güsewell, Sabine; Schmid, Hans‐Peter; Ren, Qun; Abt, Dominik

doi:10.1016/j.urology.2019.08.028

Cited by 13 publications

(10 citation statements)

References 17 publications

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“…Therefore, we determined the in vivo antibacterial activity through evaluating the risk of bacteriuria. In comparison to permanent implant materials, the constantly degrading surface of JQ alloy could completely inhibit biofilm formation, and therefore reducing most of the complications related to peri-infections [ 7 , 17 ]. In an examination of antimicrobial activities of biodegradable magnesium based materials, Nguyen et al [ 19 ] identified several possible mechanisms of antimicrobial activity that may occur as a single activity or in tandem, including oxidative stress, interruption of quorum sensing processes, and changes in Ca 2+ ion concentrations in extracellular fluids that result from the degradation of magnesium.…”

Section: Discussionmentioning

confidence: 99%

“…14%. Traditional permanent metallic ureteral stents can hardly get rid of the problems brought by biofilm formation due to the constant interface between stents and urine [ 7 , 10 ]. By contrast, magnesium ureteral stents represented by JQ stents are completely biodegradable.…”

Section: Discussionmentioning

confidence: 99%

“…Polymers are the most widely used traditional materials for the manufacture of ureteral stents, especially the double-J stents, in which are especially suitable for short term treatment. However, frequent replacement is necessary to prevent various complications, including encrustation, peri-infections, recurrent stenosis and even tumor ingrowth [ 6 , 7 ]. Compared to polymer based ureteral implant materials, metallic materials has higher inherent antibacterial activity and better mechanical performance [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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In vivo urinary compatibility of Mg-Sr-Ag alloy in swine model

Tie

Hort

Chen

et al. 2022

Bioactive Materials

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A biodegradable metallic ureteral stent with suitable mechanical properties and antibacterial activity remains a challenge. Here we reveal the scientific significance of a biodegradable Mg-Sr-Ag alloy with a favorable combination of balanced mechanical properties, adjustable indwelling time in urinary tract and evident antibacterial activity via in vivo experiments in a swine model. Attributed to the rheo-solidification process, equiaxial microstructure and significantly refined grains (average grain size: 27.1 μm) were achieved. Mg 17 Sr 2 and Mg 4 Ag were found as the primary precipitates in the matrix, due to which the alloy obtained ca. 111% increase in ultimate tensile strength in comparison to pure magnesium. Both the in vitro and in vivo results demonstrated the satisfactory biocompatibility of the alloy. Histological evaluation and bioindicators analysis suggested that there was no tissue damage, inflammation and lesions in the urinary system caused by the degradation process. The stent also improved the post-operative bladder functions viewed from the urodynamic results. Our findings highlight the potential of this alloy as antibacterial biodegradable urinary implant material.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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In vivo urinary compatibility of Mg-Sr-Ag alloy in swine model

Tie

Hort

Chen

et al. 2022

Bioactive Materials

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“…However, there is no significant correlation between the volume of encrustation and catheter-associated symptoms [25]. Yet, studies looked at the quantification of encrustations depending on the indwelling time, the differentiation of bacterial colonization, and risk factors associated with these processes [26][27][28][29]. Roupret et al found for ureteral stents with a mean indwelling time of 55.5 days a correlation between stone composition and catheter encrustation of over 70% [30].…”

Section: Risk Factors and Complications Of Encrustations On Stents An...mentioning

confidence: 99%

Encrustation in Urinary Stents

2022

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Ureteral stent placement is an acute measure to restore the urinary flow from the kidney to the bladder in cases of acute or chronic obstruction or a functional disturbance of ureteral peristalsis. In cases with chronic obstruction and poor prognosis due to surgical or sometimes patient preference, ureteral stenting may be used as a permanent treatment. With long-dwell time ureteral stenting, the problems of stent encrustation, biofilm formation, and bacterial colonization become important. Excessive stent encrustation to stent blockage and, consequently, pain, fever, renal infection, impairment of renal function and even renal failure. Encrustations of urinary stents are due to the crystallization of soluble minerals in urine, predominantly calcium oxalate salts. The quantification of this process is highly individualized. This process can occur without significant bacterial contamination but facilitates the adherence, persistence and multiplication of bacteria in biofilms. Uropathogenic microorganisms are either introduced into the bladder when a stent is inserted, or they migrate into the bladder along a transurethral catheter over time.Work is underway for new concepts to develop biomaterials with reduced encrustation propensity and biofilm formation. Promising candidates are coated materials with anti-adhesive properties through covalent binding, high hydrophilicity, and good mechanical properties allowing for adequate patient comfort. Taken together, the use of urinary stents or catheters is characterized by three interrelated problems: a tendency for encrustations through the deposition of urinary crystal-forming ions, facilitation of bacterial colonization and persistence despite antibiotic prophylaxis/treatment, and mechanical irritation with resulting reaction of the ureteral tissues.

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“… 5 As a result, it is considered that the formation of BF may be a key contributory factor to the relapse and intractability of urinary tract infections. 6 Therefore, the analysis of BF formation in patients with malignancy undergoing double J stent indwelling and the exploration of factors affecting urinary tract infection in patients are of great significance for clinical treatment. The results are reported as follows.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Bacterial Biofilm Formation in Patients with Malignancy Undergoing Double J Stent Indwelling and Its Influencing Factors

Zeng¹,

Zhang²,

Li³

et al. 2021

IDR

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To analyze the bacterial biofilm (BF) formation in patients with malignancy undergoing double J stent indwelling and its influencing factors. Methods: A total of 167 patients with malignant tumors who received double J stent indwelling in the hospital from January 2018 to January 2021 were included in the study. The urine and double J stent samples were collected for bacterial identification and observed for BF formation on the surface of the urinary catheter under a scanning electron microscope (SEM). Univariate and multivariate logistic regression analyses were used to analyze the influencing factors of BF. Results:The BF formation rate was 34.73% (58/167). The BF formation rate of positive specimens cultured in urine and double J stent was significantly higher than that of negative ones (P<0.05). Staphylococcus was the main BF bacteria in double J stent and urine culture specimens, followed by Enterococcus, Pseudomonas, Enterobacter, and Acinetobacter. Compared with the non-BF group, the number of viable bacteria in the double J stent and urine and the catheterization time in the BF group rose markedly (P<0.05). Advanced age, chemotherapy, anemia, indwelling time ≥90d, and urinary tract infection were risk factors for BF formation in patients with malignancy undergoing double J stent indwelling (P<0.05). Conclusion:There is a high rate of BF formation in patients with malignancy undergoing double J stent indwelling, with Staphylococcus as the dominant species. Treatment requires enhanced urinary catheter management and nutritional status to inhibit BF formation and lower the rate of urinary catheter-related infections.

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Symptoms Associated With Long-term Double-J Ureteral Stenting and Influence of Biofilms

Cited by 13 publications

References 17 publications

In vivo urinary compatibility of Mg-Sr-Ag alloy in swine model

In vivo urinary compatibility of Mg-Sr-Ag alloy in swine model

Encrustation in Urinary Stents

Analysis of Bacterial Biofilm Formation in Patients with Malignancy Undergoing Double J Stent Indwelling and Its Influencing Factors

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