Encrustation of the ureteral double-J Stents made of styrene/ethylene/butylene and polyurethane before and after implantation

Abstract

Purpose: The aim of this study was to determine the affinity to crystal, calculi and biofilm deposition on ureteral double-J stents (DJ stents) after ureterorenoscopic–lithotripsy procedure (URS-L). The analysis was performed in two aspects: to determine which material used for fabricating ureteral stents promotes encrustation and which part of the DJ stents is the most vulnerable for blockage. Methods: One hundred and twenty patients with an indwelling DJ stent duration between 7 and 78 days were included in this study. The encrustation of DJ stents was characterized by scanning electron microscopy (SEM), and the mechanical properties of DJ stents were examined using the standard MTS Micro Bionix tensile test. Results: This study showed that polyurethane catheters have a much higher affinity for encrustation than styrene/ethylene/butylene block copolymer. Obtained results indicated the proximal (renal pelvis) and distal (urinary bladder) part is the most susceptible to post-URS-L fragments and urea salt deposition. Both the DJ ureteral stents’ outer and inner surfaces were completely covered even after 7 days of implantation. Conclusions: Performed analysis pointed out that polyurethane DJ stents have a much higher affinity for encrustation of calculi and NaCl crystals compared to the silicone-based copolymer. The surface of the ureteral stents needs improvement to minimize salt and kidney stone deposition, causing pre-biofilm formation and the occurrence of defects and cracks.