Developments in Ureteral Stent Technology

Abstract

Ureteral stents have been utilized for decades in maintaining ureteral patency, most commonly after ureteroscopy in the treatment of urolithiasis. Since their initial development, ureteral stents have had many technological advances that have allowed for better patient outcomes with improvements in comfort, durability, patency, encrustation resistance, biocompatibility, ease of insertion, migration, and biofilm development. Several new ureteral stents enter the market every year, each with their own touted benefits. It is essential to understand the different advantages for each ureteral stent to provide the best available care to patients when possible. The purpose of this review is to give a brief history of ureteral stent development and summarize the recent developments in ureteral stent designs. We aim to review the data supporting the clinical advantages of the latest ureteral stents available for use by urologists.

Case Report: A Calculus-Free Ureteral Stent Forgotten for 29 Years

“…Stents are usually placed for 2 to 12 weeks (11). Newer ureteral stents can remain in place for more extended periods (6 months to 1 year) (15). However, the stent itself is a foreign object that causes a series of rejection reactions.…”

Case – An invisible stent

“…Ureteric stents are widely employed to maintain ureteral patency. Modern innovations in stent materials and coatings [5][6][7] continue to strive for the "ideal" ureteric stent 7,8 that maximizes biocompatibility 9,10 and ease of use, while minimizing complications such as biofilm formation and encrustation 11,12 . The modern silicone stent -such as used for our patient -has a number of advantages including patient comfort and low risk of encrustation, which makes it a recommended choice over other stent types for many indications 5 .…”

“…Modern innovations in stent materials and coatings [5][6][7] continue to strive for the "ideal" ureteric stent 7,8 that maximizes biocompatibility 9,10 and ease of use, while minimizing complications such as biofilm formation and encrustation 11,12 . The modern silicone stent -such as used for our patient -has a number of advantages including patient comfort and low risk of encrustation, which makes it a recommended choice over other stent types for many indications 5 . One study examining the effects of chronic exposure to urine on various stent materials demonstrated that after soaking in artificial urine for 14 weeks, silicone stents had the lowest rates of encrustation compared to other stents 13 .…”

“…However, despite radiopacity being a primary feature of the "ideal" stent 8 , few innovations have targeted the long-term maintenance of stent opacity [5][6][7]14 , especially in the context of chronic urine exposure. This may be owing to the rarity of this complication, and the general practice of stent changes every few months that minimize opportunities for material degradation.…”

Application, Advancement, and Complication of Ureteral Stent and Encrustation: A Major Complication

“…However, any substance covering a stent alters its natural physical properties (for example, a protein conditioning layer or bacterial biofilm), which might cause crystals to develop on the stent surface. Additionally, the surface properties of the stent have more time to change and crystallize to form the longer the stent has been in place [ 7 ].…”