Ureteral stent symptoms and associated infections: a biomaterials perspective.
Ureteral stents are commonly used in the field of urology, and, given their indwelling nature, are often a nidus for infection and a cause of discomfort. To minimize symptoms, the urologic surgeon should first consider whether a stent needs to be placed at all. Softer stents do not seem to improve patient comfort. Stents that are too long, specifically those that cross the midline of the bladder, significantly increase the frequency of stent-related symptoms. Administering alpha blockers while the stent is indwelling can reduce these symptoms. Antibiotic prophylaxis or concomitant antibiotic administration does not seem to reduce the incidence of stent-related urinary tract infection. At present, drug-eluting stents have shown the most promise for inhibiting bacterial adhesion and biofilm formation. Future stent designs that maintain drainage of the kidney and ureter while minimizing inflammation and contact with the urothelium will improve patient outcomes. By better understanding the basic pathways of bacterial adhesion to biomaterials, new stents and medications that target these mechanisms can be developed to eliminate bacterial adhesion and infection in patients with ureteral stents.
Chew
Ben H
BH
Department of Urologic Sciences, University of British Columbia, Vancouver, Canada. ben.chew@ubc.ca
Lange
Dirk
D
D000818:Animals; D001672:Biocompatible Materials / Q000009:adverse effects*; D054855:Drug-Eluting Stents / Q000009:adverse effects / Q000382:microbiology; D006801:Humans; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D015607:Stents / Q000009:adverse effects* / Q000382:microbiology*; D014515:Ureteral Diseases / Q000209:etiology* / Q000382:microbiology
D001672:Biocompatible Materials