Platinum open access journal
pISSN 2466-0493 eISSN 2466-054X
Indexed in MEDLINE, SCIE, Scopus, DOAJ and more
    Korean J Urol. 2006 Aug;47(8):895-902. Korean.
    Published online Aug 31, 2006.
    https://doi.org/10.4111/kju.2006.47.8.895
    Copyright © 2006 The Korean Urological Association
    Original Article

    The Evaluation of a Dissolvable Ureteral Catheter in a Rabbit Model

    Jae Sung Lim, Dong Seok Han, Geon Gil, Ju Hyun Shin, Seong Min So, Yong Woong Kim, Seung Mo Yuk, Hong Sik Kim, Yool Ro Yoon,1 Chong Koo Sul and Yong Gil Na
      • Department of Urology, Chungnam National University College of Medicine, Daejeon, Korea.
      • 1Yun Hap Urologic Clinic, Daejeon, Korea.
    • Corresponding author (Email: yongna@cun.ac.kr )
    Received January 11, 2006; Accepted May 31, 2006.

    Abstract

    Purpose

    Ureteral stents are commonly placed after routine ureteroscopic procedures to prevent acute obstruction. However, stents can cause significant symptoms and they can require a secondary procedure for removal; further, they may possibly be forgotten. In order to overcome these problems, a temporary ureteral drainage stent capable of dissolving spontaneously was developed to evaluate the tissue reaction and toxicity.

    Materials and Methods

    We developed a dissolvable ureteral catheter composed of polydioxanone (PDO). We evaluated the toxicity and tissue reaction by hematologic (CBC, aminotransferase/alanine transaminase (AST/ALT), blood urea nitrogen, creatinine (BUN, Cr), alkaline phosphatase) and histologic examination (ureter, kidney and liver tissue). Twelve rabbits were placed into groups of four rabbits each: the uninserted control group, group I that had a dissolvable ureteral catheter inserted with harvest at four weeks, group II that had a dissolvable ureteral catheter inserted with harvest at eight weeks, and group III that had a dissolvable ureteral catheter inserted with harvest at twelve weeks.

    Results

    On histologic examination, the ureter had a normal appearance of transitional cells and it contained the dissolvable ureteral catheter in the ureteral lumen without any inflammatory change. The ureteral surface cells appeared normal after contact with the dissolvable ureteral catheter during the 12 weeks. Liver and kidney tissue showed mild focal inflammatory change, but no definitive difference was noted between the control and groups I, II and III. On the hematologic examination, there was no significant change of the value of CBC, AST/ALT, BUN, Cr and alkaline phosphatase due to the inserted dissolvable ureteral catheter during the 12 weeks.

    Conclusions

    A dissolvable ureteral catheter appeared to have no toxic effect, as evidenced by histological and hematological examination. However, further study is warranted in order to overcome the catheter's limitations like for its flexibility.

    Keywords
    Ureteral catheterization

    Figures

    Fig. 1
    (A) Preparation of p-dioxanone monomer via dehydrogenation, (B) polymerization mechanisms of p-dioxanone to poly (p-dioxanone).

    Fig. 2
    The shape of the dissolving ureteral catheters.

    Fig. 3
    Fluid collection method.

    Fig. 4
    Weight loss of the polydioxanone ureteral stent according to the immersion time.

    Fig. 5
    The change of the polydioxanone ureteral catheter surface according to the immersion time. (A) 0 weeks, (B) 8 weeks, (C) 20 weeks, (D) 28 weeks.

    Fig. 6
    The change of the polydioxanone ureteral catheter surface as viewed by scanning electron microscopy (SEM). (A) Control, (B) 2 week later, (C) 8 week later, (D) control (Lt) and 8 week later (Rt).

    Fig. 7
    7. Histological examination of the ureteral cross section after 4 weeks of the indwelling dissolvable ureteral catheter. Normal appearance of the ureteral transitional cells. There are no visible inflammatory changes and the arrow indicates the dissolving ureteral catheter in the ureteral lumen (H&E stain, ×40). (A) Group I, (B) Group II, (C) Group III.

    Fig. 8
    Histological examination of the ureteral cross section after 4 weeks of the indwelling ureteral catheter (A) and the indwelling dissolving ureteral catheter (B) (H-E stain, ×40).

    Tables

    Table 1
    Measurements of flow resistance

    Table 2
    The results of hematologic examination and urine analysis

    References

      1. Zimskind PD, Fetter TR, Wikerson JL. Clinical use of long-term indwelling silicone rubber ureteral splints inserted cystoscopically. J Urol 1967;97:840–844.
      1. Pryor JL, Langley MJ, Jenkins AD. Comparison of symptom characteristics of indwelling ureteral catheters. J Urol 1991;145:719–722.
      1. Bregg K, Riehle RA Jr. Morbidity associated with indwelling internal ureteral stents after shock wave lithotripsy. J Urol 1989;141:510–512.
      1. Pollard SG, Macfarlane R. Symptoms arising from Double-J ureteral stents. J Urol 1988;139:37–38.
      1. Lennon GA, Thornhill JA, Sweency PA, Grainger R, Mc-Dermott TE, Butler MR. 'Firm' versus 'soft' double pigtail ureteric stents: a randomised blind comparative trial. Eur Urol 1995;28:1–5.
      1. Irani J, Siquier J, Pires C, Lefebvre O, Dore B, Aubert J. Symptom characteristics and development of tolerance with in patient with indwelling double-pigtail ureteric stents. BJU Int 1999;84:276–279.
      1. Joshi HB, Okeke A, Newns N, Keeley FX Jr, Timoney AG. Characterization of urinary symptoms in patients with ureteral stents. Urology 2002;59:511–516.
      1. Seo KK, Oh CH, Moon YT. Complication of indwelling double-J ureteral stents. Koren J Urol 1990;31:754–758.
      1. Pryor JL, Jenkins AD. Use of double-pigtail stents in extracorporeal shock wave lithotripsy. J Urol 1990;143:475–478.
      1. Joshi HB, Stainthorpe A, MacDonagh RP, Keeley FX Jr, Timoney AG, Barry MJ. Indwelling ureteral stents: evaluation of symptoms, quality of life and utility. J Urol 2003;169:1065–1069.
      1. Joshi HB, Newns N, Stainthorpe A, MacDonagh RP, Keeley FX Jr, Timoney AG. Ureteral stent symptom questionnaire: development and validation of a multidimensional quality of life measure. J Urol 2003;169:1060–1064.
      1. Joshi HB, Newns N, Stainthorpe A, MacDonagh RP, Keeley FX Jr, Timoney AG. The development and validation of a patient-information booklet on ureteric stents. BJU Int 2001;88:329–334.
      1. Netto NR Jr, Ikonomidis J, Zillo C. Routine ureteral stenting after ureteroscopy for ureteral lithiasis: Is it really necessary? J Urol 2001;166:1252–1254.
      1. Hosking DH, Mccolm SE, Smith WE. Is stenting following ureteroscopy for removal of distal ureteral calculi necessary? J Urol 1999;161:48–50.
      1. Noh JH, Kim DK, Jeong H. Comparison of stented and unstented patients following ureteroscopy for ureter stones. Korean J Urol 2002;43:28–31.
      1. Denstedt JD, Wollin TA, Sofer M, Nott L, Weir M, D'A Honey RJ. A prospective randomized controlled trial comparing nonstented versus stented ureteroscopic lithotripsy. J Urol 2001;165:1419–1422.
      1. Byrne RR, Auge BK, Kourambas J, Munver R, Delvecchio F, Preminger GM. Routine ureteral stenting is not necessary after ureteroscopy and ureteropyeloscopy: a randomized trial. J Endourol 2002;16:9–13.
      1. Hollenbeck BK, Schuster TG, Faerber GJ, Wolf JS Jr. Routine placement of ureteral stents is unnecessary after ureteroscopy for urinary calculi. Urology 2001;57:639–643.
      1. Chen YT, Chen J, Wong WY, Yomg SS, Hsieh CH, Wang CC. Is ureteral stenting necessary after umcomplicated ureteroscopic lithotripsy? A prospective, randomized controlled trial. J Urol 2002;167:1977–1980.
      1. Beiko DT, Knudsen BE, Watterson JD, Cadieux PA, Reid G, Denstedt JD. Urinary tract biomaterials. J Urol 2004;171:2438–2444.
      1. Olweny EO, Portis AJ, Sundaram CP, Afane JS, Humphrey PA, Ewers R, et al. Evaluation of a chronic indwelling prototype mesh ureteral stent in a porcine model. Urology 2000;56:857–862.
      1. Taylor WN, McDougall IT. Minimally invasive ureteral stent retrieval. J Urol 2002;168:2020–2023.
    Cited by
    Crossref 1
    Google Scholar 
    Scopus 1
    MeSH Terms
    Alkaline Phosphatase
    Blood Urea Nitrogen
    Creatinine
    Drainage
    Kidney
    Liver
    Pliability
    Polydioxanone
    Rabbits
    Stents
    Ureter*
    Urinary Catheterization
    Urinary Catheters*
    Metrics
    Share
    Figures
    slide
    slide
    slide
    slide
    slide
    slide
    slide
    slide

    1 / 8

    Tables
    slide
    slide

    1 / 2

    PERMALINK