Introduction. Ureteral stent encrustation significantly limits indwelling time and can lead to downstream urologic problems. However, no ideal polymeric biomaterials have been shown to completely resist encrustation in long-term urine exposure. Recently, 2-hydroxyethyl methacrylate (HEMA)-coated Pellethane was reported as a promising biomaterial resistant to encrustation. This study compared HEMA-coated Pellethane to commercially available stents under two different artificial urine environments. Objective. To evaluate the degree and composition of encrustation on HEMA-coated Pellethane, Boston Scientific Tria, Bard InLay Optima, Cook Universa® Hydrogel, and Cook Black Silicone stent at various dwelling times in two different artificial urine environments. Design. In a batch-flow model, samples of stents were suspended in an artificial urine solution (AUS) at 37°C. Every 24-hours for 11 weeks, 50% of the AUS would be replaced with new components using a programmable peristaltic pump system. Stent materials were removed at suitable time intervals and air-dried for 24 hours under sterile conditions before follow-up analysis. Scanning electron microscopy (SEM) was used to assess the degree of encrustation and inductively coupled plasma mass spectrometry (ICP-MS) was employed to quantify the encrusted compositions, specifically for calcium, magnesium, and phosphorus. Outcome Measurements and statistical analysis. We measured the weight gain over time due to encrusted deposits on the stents and quantified the amount of Ca, Mg, and P deposited on each encrusted stent. Results and Limitations. After the 11-week trial, HEMA-coated Pellethane had the most average mass change. SEM showed that HEMA-coated Pellethane was fully encrusted in just two weeks in the AUS environments and ICP-MS showed that Ca is the most abundant deposit. Among all the tested stents, Black Silicone performed the best. The two AUS were formulated to encrust more rapidly than physiological conditions. Conclusions. HEMA-coated Pellethane is not an ideal stent material, while silicone is a promising material for advancing ureteral stents.

Comparison of ureteral stent biomaterials: Encrustation profile in metabolic and infectious artificial urine models

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ACS Fall 2022

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