7.41 Ureteral Stents Technology: Biodegradable and Drug-Eluting Perspective

Barros, Alexandre A.; Oliveira, Carlos; Lima, Estêvão; Duarte, Ana Rita C.; Healy, Kevin E.; Reis, Rui L.

doi:10.1016/b978-0-12-803581-8.10189-4

Cited by 12 publications

(18 citation statements)

References 116 publications

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“…These bladder stones can store pathogens, reinfecting the bladder and allowing the biofilm crystallisation of a new catheter, thus perpetuating the cycle [ 29 ]. Morris et al [ 28 ] and more recently Barros et al [ 30 ] describe the development of a crystallised biofilm on the surface of urinary devices as follows: The urinary tract is infected by a urease-producing bacterial species The surface of the catheter is prepared for bacteria adhesion by the production of an organic conditioning film by the deposition of urine components, ions, and minerals The urease-producing bacteria adhere to the conditioning film The biofilm community begins to form as they excrete an exopolysaccharide matrix As bacterial numbers rise in the biofilm, so does the release of urease that goes on to hydrolyse urea into ammonia, increasing the pH of both the urine and the biofilm Calcium and magnesium ions are attracted to the biofilm's gel matrix The calcium and magnesium phosphate crystallise, forming struvite and apatite crystals on the device's surface bound with the biofilm …”

Section: Crystalline Biofilmsmentioning

confidence: 99%

Review of Catheter-Associated Urinary Tract Infections and In Vitro Urinary Tract Models

Cortese

Wagner

Tierney

et al. 2018

Journal of Healthcare Engineering

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Catheter-associated urinary tract infections (CAUTIs) are one of the most common nosocomial infections and can lead to numerous medical complications from the mild catheter encrustation and bladder stones to the severe septicaemia, endotoxic shock, and pyelonephritis. Catheters are one of the most commonly used medical devices in the world and can be characterised as either indwelling (ID) or intermittent catheters (IC). The primary challenges in the use of IDs are biofilm formation and encrustation. ICs are increasingly seen as a solution to the complications caused by IDs as ICs pose no risk of biofilm formation due to their short time in the body and a lower risk of bladder stone formation. Research on IDs has focused on the use of antimicrobial and antibiofilm compounds, while research on ICs has focused on preventing bacteria entering the urinary tract or coming into contact with the catheter. There is an urgent need for in vitro urinary tract models to facilitate faster research and development for CAUTI prevention. There are currently three urinary tract models that test IDs; however, there is only a single very limited model for testing ICs. There is currently no standardised urinary tract model to test the efficacies of ICs.

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Section: Crystalline Biofilmsmentioning

confidence: 99%

Review of Catheter-Associated Urinary Tract Infections and In Vitro Urinary Tract Models

Cortese

Wagner

Tierney

et al. 2018

Journal of Healthcare Engineering

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“…In addition to pediatric/adolescent-specific stent creation, the development of 'next generation' vaginal stents further improve on current designs by eliminating the need for postoperative stent removal after wear-time is complete. Resorbable stents are already in therapeutic use for cardiovascular applications [32] and are being developed for other organ lumens such as esophageal [33], gastrointestinal [34], and ureteral [35] applications. Transfer of this technology to pediatric gynecology in the form of vaginal stents that degrade slowly over time would allow for the same basic functionality -application of traction to the vaginal walls after surgery, maintenance of vaginal caliber during wound healing, and egress of exudative fluids, blood, and vaginal discharge to limit infection and wound breakdown -but without requiring a second procedure for removal.…”

Section: Looking Ahead: 'Next Gen' Vaginal Stents and Immersive Surgical Learningmentioning

confidence: 99%

Emerging technologies in pediatric gynecology: new paradigms in women's health care

Wancura

McCracken²,

Steen

et al. 2019

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of review-The current review highlights the complexity of the pediatric and adolescent gynecology subspecialty as well as the recent and exciting opportunities for innovation within the field.Recent findings-The opportunities for concept, treatment, instrument, and knowledge-transfer innovation to better serve the specific needs of pediatric gynecology patients include novel approaches to neovagina creation using magnets, improving postoperative vaginal wound healing through newly designed and degradable vaginal stents, and complex Mullerian reconstructive surgical planning using virtual reality immersive experiential training.

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“…Moreover, drug-eluting coatings have been devised to enable controlled release of anticancer, anti-inflammatory, or antimicrobial compounds (such as triclosan [22], tigecycline and rifampicin [23]). This latter approach has proven to be effective in limiting fibroproliferative reactions, inhibiting bacterial adhesion, and reducing formation of biofilms and encrustation [20,24,25]. Another important area of stent design that has been the focus of engineers and scientists, is the one of stent's constitutive materials [14].…”

Section: Introductionmentioning

confidence: 99%

“…Metals, inert polymers, and biodegradable materials are the three main types of substrates used in stent manufacturing [5,6,13,21]. Biodegradable materials have been investigated more recently because of their excellent biocompatibility [25]. Moreover, their porous structure can be permeated by biological fluids, can act as a reservoir for the release of active pharmaceutical ingredients [26,27], or can degrade over time thus avoiding the need for stent removal through surgical intervention [5,28,29].…”

Section: Introductionmentioning

confidence: 99%

Computational simulation of the flow dynamic field in a porous ureteric stent

Yang

Mosayyebi

Carugo

2022

Med Biol Eng Comput

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Ureteric stents are employed clinically to manage urinary obstructions or other pathological conditions. Stents made of porous and biodegradable materials have gained increasing interest, because of their excellent biocompatibility and the potential for overcoming the so-called ‘forgotten stent syndrome’. However, there is very limited characterisation of their flow dynamic performance. In this study, a CFD model of the occluded and unoccluded urinary tract was developed to investigate the urinary flow dynamics in the presence of a porous ureteric stent. With increasing the permeability of the porous material (i.e., from 10−18 to 10−10 m2) both the total mass flow rate through the ureter and the average fluid velocity within the stent increased. In the unoccluded ureter, the total mass flow rate increased of 7.7% when a porous stent with permeability of 10−10 m2 was employed instead of an unporous stent. Drainage performance further improved in the presence of a ureteral occlusion, with the porous stent resulting in 10.2% greater mass flow rate compared to the unporous stent. Findings from this study provide fundamental insights into the flow performance of porous ureteric stents, with potential utility in the development pipeline of these medical devices. Graphical abstract

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7.41 Ureteral Stents Technology: Biodegradable and Drug-Eluting Perspective

Cited by 12 publications

References 116 publications

Review of Catheter-Associated Urinary Tract Infections and In Vitro Urinary Tract Models

Review of Catheter-Associated Urinary Tract Infections and In Vitro Urinary Tract Models

Emerging technologies in pediatric gynecology: new paradigms in women's health care

Computational simulation of the flow dynamic field in a porous ureteric stent

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