Surface analysis of ureteral stent before and after implantation in the bodies of child patients
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ORIGINAL PAPER
Surface analysis of ureteral stent before and after implantation in the bodies of child patients Katarzyna Arkusz1 · Kamila Pasik1 · Andrzej Halinski2 · Adam Halinski2 Received: 6 May 2020 / Accepted: 25 August 2020 © The Author(s) 2020
Abstract The aim of this work was to determine which part of a double-J ureteral stent (DJ stents) showed the highest tendency to crystal, calculi, and biofilm deposition after ureterorenoscopic-lithotripsy procedure (URS-L) to treat calcium oxalate stones. Additionally, the mechanical strength and the stiffness of DJ stents were evaluated before and after exposure to urine. Obtained results indicated that the proximal (renal pelvis) and distal (urinary bladder) part is the most susceptible for post-URS-L fragments and urea salt deposition. Both, the outer and inner surfaces of the DJ ureteral stents were completely covered even after 7 days of implantation. Encrustation of DJ stents during a 31-day period results in reducing the Young’s modulus by 27–30%, which confirms the loss of DJ stent elasticity and increased probability of cracks or interruption. Performed analysis pointed to the need to use an antibacterial coating in the above-mentioned part of the ureteral stent to prolong its usage time and to prevent urinary tract infection. Keywords Ureterorenoscopic-lithotripsy procedure · Ureteral stent · Kidney stone · Scanning electron microscopy · Mechanical strength
Introduction Nephrolithiasis is a frequent cause of morbidity (12%) in the world population, and half of those affected will have recurrent stone disease [1]. Previous research on urinary stones considered only adult patients, completely omitting the paediatric population, whereas there is mounting evidence for increased stone formation in younger patients [2]. Shock wave lithotripsy is in majority of the cases the firstline treatment method to eliminate the kidney stones. In case of ureteral stones, especially in the lower part of the ureter ureterorenoscopic-lithotrypsy (URS-L) procedure might be performed. After surgery, the implantation of a double-J ureteral stent may be needed. There are absolute indications for stent insertion, which include relief of obstructed pyelonephritis, bilateral ureteral obstruction, ureteric injuries, * Katarzyna Arkusz [email protected] 1
Department of Biomedical Engineering, Faculty of Mechanical Engineering, University of Zielona Gora, 9 Licealna Street, 65‑417 Zielona Gora, Poland
Department of Paediatric Urology, Cherry Clinic, Anieli Krzywon 2 Street, 65‑534 Zielona Gora, Poland
2
and post-treatment of urolithiasis in patients with a solitary kidney [3, 4]. As no ideal stent, many problems of stent migration, occlusion, encrustation, fragmentation, and stone formation were noticed. The materials used for the production of ureteral stents should comply with a number of specifications. Materials required for urinal catheterization should have a smooth surface (low surface roughness) [5], high mechanical strength, and flexibility [6], and they
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