title: Ureteral stents should be soaked for several minutes before placement.
abstract: OBJECTIVE
  Placement of ureteral stents (DJ-stents) may lead to complications. Inappropriate friction properties of the implant are, inter alia, made responsible for primary injuries, injury-related inflammation and a cascade of consecutive side effects. Hydrophilicity is considered to be related to low friction. The question arises, whether the various products on the market show their respective maximum hydrophilicity directly after unwrapping or a pre-use moistening, as already routinely done with the guide wire, is necessary.
  
  
  METHODS
  The surface wettability of commercial and experimental DJ-stents was determined by water contact angle (WCA) measurements using the sessile drop method. One reference surface and 11 different stent surface types were tested. In order to determine the influence of moistening on the stents' surface wettability, WCAs were measured twice, with dry, and soaked (30 min, 0.9%-NaCl) specimens. Each sample of a surface type was tested at three different positions to avoid effects of surface heterogeneities. Up to six samples of the same surface type were examined.
  
  
  RESULTS
  Mean WCAs on fresh and soaked stent surfaces ranged from 75°-103° and 71°-99°. In every case the WCAs on soaked surfaces were lower. On average the WCAs decrease by 7%, the individual decreases differ considerably, from 2 to 16%. For 7/12 of the examined surface types, the decrease in contact angle is statistically significant with p ≤ 0.01.
  
  
  CONCLUSIONS
  DJ-stents freshly unwrapped show less hydrophilic properties compared to DJ-stents soaked in saline. To obtain maximum hydrophilicity at stent placement, DJ-stents should be soaked. The results may advocate a similar approach for other urological equipment.
authors.affiliation: Deutsches Harnsteinzentrum, Urologisches Zentrum Bonn Friedensplatz, Friedensplatz 16, 53111 Bonn, Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Laube
authors.affiliation: NTTF Coatings GmbH, Maarweg 32, 53619 Rheinbreitbach, Germany.
authors.forename: Chintan
authors.initials: C
authors.lastname: Desai
authors.affiliation: NTTF Coatings GmbH, Maarweg 32, 53619 Rheinbreitbach, Germany.
authors.forename: Falk
authors.initials: F
authors.lastname: Bernsmann
authors.affiliation: Klinik für Urologie und Kinderurologie, Universitätsklinikum Bonn, Sigmund-Freud-Straße 25, 53127 Bonn, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Fisang
keywords: DJ-stent; Friction; Hydrophilicity; Moistening; Surface free energy; Wettability