The Morphological, in Situ Effects of a Self-Reinforced Bioabsorbable Polylactide (Sr-Pla 96) Ureteric Stent; An Experimental Study

Lumiaho, Juha; Heino, Antero; Pietiläinen, Timo; Ala‐Opas, Martti; Talja, Martti; Välimaa, Tero; Törmälä, Pertti

doi:10.1016/s0022-5347(05)67199-6

Cited by 46 publications

(11 citation statements)

References 16 publications

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“…In addition to pain, indwelling stents stimulate and irritate the bladder mucous membrane, resulting in a wide range of urinary symptoms including dysuria, urgency, hematuria and UTI. Experiments showed that long-indwelling stents cause ureteral wall edema, epithelial hyperplasia, destruction, and inflammatory cell reactions, suggesting their use only over the short term [42]. Usually 4 weeks after stent implantation, late complications appear such as hydronephrosis, stent migration, encrustation, fragmentation and breakage [43].…”

Section: Discussionmentioning

confidence: 99%

Meta-Analysis of Stenting versus Non-Stenting for the Treatment of Ureteral Stones

Wang

Man

et al. 2017

PLoS ONE

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Background and aimUreteroscopic lithotripsy (URL) and extracorporeal shock wave lithotripsy (ESWL) are two widely used methods for the treatment of ureteral stones. The need for ureteral stenting during these procedures is controversial. In this meta-analysis, we evaluated the benefits and disadvantages of ureteral stents for the treatment of ureteral stones.MethodsDatabases including PubMed, Embase and Cochrane library were selected for systematic review of randomized controlled trials (RCTs) comparing outcomes with or without stenting during URL and ESWL. Meta-analysis was performed using RevMan 5.3 and STATA 13.0 software.ResultsWe identified 22 RCTs comparing stenting and non-stenting. The stented group was associated with longer operation time (WMD: 4.93; 95% CI: 2.07 to 7.84; p < 0.001), lower stone-free rate (OR: 0.55; 95% CI: 0.34 to 0.89; p = 0.01). In terms of complications, the incidence of hematuria (OR: 3.68; 95% CI: 1.86 to 7.29; p < 0.001), irritative urinary symptoms (OR: 4.40; 95% CI: 2.19 to 9.10; p < 0.001), urinary infection (OR: 2.23; 95% CI: 1.57 to 3.19; p < 0.001), and dysuria (OR: 3.90; 95% CI: 2.51 to 6.07; p < 0.001) were significantly higher in the stented group. No significant differences in visual analogue score (VAS), stricture formation, fever, or hospital stay were found between stenting and non-stenting groups. The risk of unplanned readmissions (OR: 0.63; 95% CI: 0.41 to 0.97; p = 0.04) was higher in the non-stented group.ConclusionsOur analysis showed that stenting failed to improve the stone-free rate, and instead, it resulted in additional complications. However, ureteral stents are valuable in preventing unplanned re-hospitalization. Additional randomized controlled trials are still required to corroborate our findings.

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Section: Discussionmentioning

confidence: 99%

Meta-Analysis of Stenting versus Non-Stenting for the Treatment of Ureteral Stones

Wang

Man

et al. 2017

PLoS ONE

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“…Studies in animal models have revealed biological reactions to stent insertion in the form of epithelial destruction with erosions, ulcerations of the transitional epithelium, and inflammatory reactive changes within 6 weeks of stenting the animals' ureter [31–34]. Thus, the mechanical trauma associated with stent placement may injure the uroepithelium, allowing for latent BK virus to enter replicative phases.…”

Section: Discussionmentioning

confidence: 99%

Ureteral Stent Placement Increases the Risk for Developing BK Viremia after Kidney Transplantation

Hashim

Rehman

Gregg

et al. 2014

Journal of Transplantation

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The placement of ureteral stent (UrSt) at kidney transplantation reduces major urological complications but increases the risk for developing nephropathy from the BK virus. It is unclear whether UrSt placement increases nephropathy risk by increasing risk of precursor viral replication or by other mechanisms. We retrospectively investigated whether UrSt placement increased the risk for developing BK Viremia (BKVM) in adult and pediatric kidney transplants performed at the University of Florida between July 1, 2007, and December 31, 2010. In this period all recipients underwent prospective BKV PCR monitoring and were maintained on similar immunosuppression. Stent placement or not was based on surgeon preference. In 621 transplants, UrSt were placed in 295 (47.5%). BKVM was seen in 22% versus 16% without UrSt (P = 0.05). In multivariate analyses, adjusting for multiple transplant covariates, only UrSt placement remained significantly associated with BKVM (P = 0.04). UrSt placement significantly increased the risk for BKVM. Routine UrSt placement needs to be revaluated, since benefits may be negated by the need for more BK PCR testing and potential for graft survival-affecting nephritis.

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“…Routine stent placement has been questioned for a long time, especially in relation to balloon dilatation and ureteroscopy for urolithiasis ( 18 ). The use of a stent is recommended only for the short period required to prevent the obstruction and renal failure due to edema, epithelial hyperplasia, or inflammatory cell reaction ( 19 ). Moreover, some authors have recently suggested that the ureteral stent is not necessary in uncomplicated procedures ( 20 , 21 ).…”

Section: Discussionmentioning

confidence: 99%

High Pressure Balloon Dilatation of Primary Obstructive Megaureter in Children: A Multicenter Study

et al. 2018

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Aim of the Study: We described the initial experience of four referral centers in the treatment of primary obstructive megaureter (POM) in children, by high-pressure balloon dilatation (HPBD) of the ureterovesical junction with double JJ stenting. We managed a retrospective multicenter study to assess its effectiveness in long-term.Methods: We reviewed the medical records of all children who underwent HPBD for POM that require surgical treatment from May 2012 to December 2017 in four different institutions. The primary outcome measured was ureterohydronephrosis (UHN) and its degree of improvement after the procedure. Secondary outcomes were postoperative complications and resolution of preoperative symptomatology.Main Results: Forty-two ureters underwent HPBD for POM in 33 children, with a median age of 14.7 months – (range: 3 months −15 years). Ureterohydronephrosis improves in 86% of ureters after one endoscopic treatment. Three cases required a second HPBD. Four patients required surgical treatment for worsening of UHN after endoscopic treatment. The post-operative complication rate was 50% (21 ureters). In 13 cases (61%), they were related to double J stent. The median follow-up was 24 months (2 months −5 years) and all patients were symptom-free.Conclusion: We reported the first multicenter study and the largest series of children treated with HPBD, with an overall success rate of 92%. Endoscopic treatment can be a definitive treatment of POM since it avoided reimplantation in 90% of cases. Complications are mainly due to double J stent.

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The Morphological, in Situ Effects of a Self-Reinforced Bioabsorbable Polylactide (Sr-Pla 96) Ureteric Stent; An Experimental Study

Abstract: SR-PLA 96 spiral stent is regarded highly compatible and SR-PLA 96 might be a suitable material for a partial ureteric stent. Biodegradation of a SR-PLA 96 stent makes stent removal unnecessary.

Cited by 46 publications

References 16 publications

Meta-Analysis of Stenting versus Non-Stenting for the Treatment of Ureteral Stones

Meta-Analysis of Stenting versus Non-Stenting for the Treatment of Ureteral Stones

Ureteral Stent Placement Increases the Risk for Developing BK Viremia after Kidney Transplantation

High Pressure Balloon Dilatation of Primary Obstructive Megaureter in Children: A Multicenter Study

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