Ureteral stents should be soaked for several minutes before placement

Abstract

PurposePlacement of ureteral stents (DJ-stents) may lead to complications. Inappropriate friction properties of the implant are, inter alia, made responsible for primary injuries, injury-related inflammation and a cascade of consecutive side effects. Hydrophilicity is considered to be related to low friction. The question arises, whether the various products on the market show their respective maximum hydrophilicity directly after unwrapping or a pre-use moistening, as already routinely done with the guide wire, is necessary.MethodsThe surface wettability of commercial and experimental DJ-stents was determined by water contact angle (WCA) measurements using the sessile drop method. One reference surface and 11 different stent surface types were tested. In order to determine the influence of moistening on the stents’ surface wettability, WCAs were measured twice, with dry, and soaked (30 min, 0.9%-NaCl) specimens. Each sample of a surface type was tested at three different positions to avoid effects of surface heterogeneities. Up to six samples of the same surface type were examined.ResultsMean WCAs on fresh and soaked stent surfaces ranged from 75°–103° and 71°–99°. In every case the WCAs on soaked surfaces were lower. On average the WCAs decrease by 7%, the individual decreases differ considerably, from 2 to 16%. For 7/12 of the examined surface types, the decrease in contact angle is statistically significant with p ≤ 0.01.ConclusionsDJ-stents freshly unwrapped show less hydrophilic properties compared to DJ-stents soaked in saline. To obtain maximum hydrophilicity at stent placement, DJ-stents should be soaked. The results may advocate a similar approach for other urological equipment.

Assessment of encrustation and physicochemical properties of poly(lactide‐glycolide) ‐ Papaverine hydrochloride coating on ureteral double‐J stents after long‐term flow of artificial urine

“…Higher wettability of PLGA coatings was associated with the hydroxyl groups. The observed changes in the wettability of coated polyurethane stent surfaces and the effect of soaking on their properties were similar to those determined by other authors 42,43 . According to the literature, ureteral stents intended for implantation should have hydrophilic properties, 30,42,44 and this effect was achieved in the study.…”

“…An important feature of the ureteral stents is the wettability of the surface. Stents delivered in a dry state should be soaked immediately before the procedure, in order to facilitate their implantation 42,43 . The surface of dry polyurethane stents was hydrophobic.…”

A bilayer swellable drug-eluting ureteric stent: Localized drug delivery to treat urothelial diseases

“…The coated stent was successfully implanted and removed in the porcine ureter using the current standard protocol for stent insertion in patients. Since both the urothelial lining and hydrogels were hydrophilic and lubricious, there was no significant friction that resisted the movement of stent along the tissues [54]. The radio-opacity of the hydrogel, generated by its exposure to Omnipaque TM solution, enabled the clinician to visually locate the coated section of the device under fluoroscopic guidance.…”

Poly(polyol sebacate) Elastomers as Coatings for Metallic Coronary Stents

“…Therefore, metallic stents are still the most popular implantable devices for such cardiovascular diseases and new types of coatings are currently being developed in order to improve the stent's final functionality. Polymer‐free coatings like hydroxyapatite, titanium and iridium oxide, and carbon coatings are currently being studied but no clear long‐term safety is proven yet …”