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Heparin coating in biodegradable ureteral stents does not decrease bacterial colonization-assessment in ureteral
Federico Soria1, Julia E de La Cruz1, Tomás Fernandez2
1Endourology Department, Jesús Usón Minimally Invasive Surgery Centre Foundation, Cáceres, Spain.
Translational Andrology and Urology
|May 10, 2021
Summary
The BraidStent®-H, a new biodegradable ureteral stent, shows comparable efficacy to traditional stents in treating ureteral strictures. It offers reduced morbidity and predictable degradation, though further research on its antibacterial coating is needed.
Area of Science:
- Urology
- Biomaterials Science
- Surgical Innovation
Background:
- Ureteral strictures pose a significant clinical challenge requiring effective stenting solutions.
- Current ureteral stents can lead to complications such as vesicoureteral reflux and infection.
- Biodegradable stent technology offers a potential alternative to minimize long-term complications.
Purpose of the Study:
- To evaluate the efficacy and safety of an antireflux biodegradable heparin-coated ureteral stent (BraidStent®-H).
- To compare the BraidStent®-H against a traditional double-pigtail stent in an animal model.
- To assess stent degradation, reflux, peristalsis, and infection rates.
Main Methods:
- A comparative animal study involving 24 female pigs with induced ureteral strictures.
- Laser endoureterotomy followed by random stent placement: double-pigtail (Group-I) or BraidStent®-H (Group-II).
- Comprehensive follow-up including imaging, ureteroscopy, urinalysis, and pathological examination.
Main Results:
- No vesicoureteral reflux was observed in the BraidStent®-H group.
- Distal ureteral peristalsis was maintained in 50-75% of animals in the BraidStent®-H group.
- 91.7% of BraidStent®-H stents degraded within 3-6 weeks without obstructive fragments; global success rates were comparable between groups.
Conclusions:
- BraidStent®-H is as effective as conventional stents for benign ureteral strictures post-laser endoureterotomy.
- The biodegradable stent reduces morbidity, degrades predictably around 6 weeks, and avoids obstructive fragments.
- Further investigation into antibacterial coatings is recommended to mitigate contamination risks observed with the heparin coating.
