Assessment of encrustations on polyurethane ureteral stents.

PURPOSE To determine the composition and the extent of crystalline (and other) encrustation on ureteral catheters inserted under sterile conditions in stone formers, in comparison with catheters of the same type inserted in nonstone formers for the same time but for different clinical reasons. MATERIALS AND METHODS Forty consecutive self-retained polyurethane pigtail ureteral catheters removed by cystoscopy between November 2000 and February 2002 were studied, 30 from stone formers and 10 from patients without stone histories. The mean dwelling time was 55 days for the stone formers and 79 days for the other patients. The encrustations were collected and analyzed with Fourier-transform infrared spectroscopy, powder X-ray diffraction, or both. The stones from nine of the patients were also subjected to the same spectroscopic analysis. Representative sections of the catheters were investigated by scanning electron microscopy and energy-dispersive X-ray analysis. RESULTS The most common encrustation in stone formers was calcium oxalate monohydrate. In patients without stones, deposits of organic compounds were found consistently. The mean mass of encrustation of stone formers was larger (71.05 mg) than that of patients without stones (1 mg). CONCLUSIONS Calcium oxalate is the predominant type of encrustation on ureteral catheters in stone formers. Prevention of heavy encrustation should be directed to therapeutic measures concerning calcium oxalate lithiasis and development of new materials by the medical industry that are less prone to encrustation.

[1]  G. Reid,et al.  Bacterial biofilm formation, encrustation, and antibiotic adsorption to ureteral stents indwelling in humans. , 1998, Journal of endourology.

[2]  O. Söhnel,et al.  Study on Concretions Developed around Urinary Catheters and Mechanisms of Renal Calculi Development , 2001, Nephron.

[3]  J. Wimpenny,et al.  Scanning electron microscopy of bacterial biofilms on indwelling bladder catheters , 1992, European Journal of Clinical Microbiology and Infectious Diseases.

[4]  G. Reid,et al.  Biomaterials used in urology: current issues of biocompatibility, infection, and encrustation. , 1998, Journal of endourology.

[5]  S. Gorman,et al.  Development of a model for assessment of biomaterial encrustation in the upper urinary tract. , 1996, Biomaterials.

[6]  D. Hukins,et al.  Infection of catheterised patients: bacterial colonisation of encrusted Foley catheters shown by scanning electron microscopy , 2004, Urological Research.

[7]  C. Fry,et al.  Catheter associated urinary tract infection and encrustation. , 2001, International journal of antimicrobial agents.

[8]  C. Riedl,et al.  Heparin coating reduces encrustation of ureteral stents: a preliminary report. , 2002, International journal of antimicrobial agents.

[9]  M. Quek,et al.  Knot formation at the mid portion of an indwelling ureteral stent. , 2002, The Journal of urology.

[10]  Y. Ohi,et al.  Bacterial biofilms and catheters in experimental urinary tract infection. , 1999, International journal of antimicrobial agents.

[11]  G. Reid,et al.  Conditioning film deposition on ureteral stents after implantation. , 1998, The Journal of urology.

[12]  A. Motta,et al.  Effect of the urine conditioning film on ureteral stent encrustation and characterization of its protein composition. , 1999, Biomaterials.

[13]  H. Whitfield,et al.  The development of synthetic polymers that resist encrustation on exposure to urine. , 1992, British journal of urology.

[14]  H. Whitfield,et al.  Urinary encrustation of alloplastic materials. , 2000, Journal of endourology.

[15]  M. Schaldach,et al.  Prevention of surface encrustation of urological implants by coating with inhibitors. , 2001, Biomaterials.

[16]  S. Gorman,et al.  Biofilm and biofilm-related encrustation of urinary tract devices. , 1999, Methods in Enzymology.

[17]  R. Autorino,et al.  Early and Late Complications of Double Pigtail Ureteral Stent , 2002, Urologia Internationalis.

[18]  H. Hedelin,et al.  The importance of glucose for the Escherichia coli mediated citrate depletion in synthetic and human urine. , 2001, Scandinavian journal of urology and nephrology.

[19]  T. Tammela,et al.  Biocompatibility, encrustation and biodegradation of ofloxacine and silver nitrate coated poly-L-lactic acid stents in rabbit urethra , 2002, Urological Research.

[20]  A. Boularan,et al.  Double-J ureteric stent encrustations: clinical study on crystal formation on polyurethane stents. , 1997, Urologia internationalis.

[21]  P. Suci,et al.  Investigation of interactions between antimicrobial agents and bacterial biofilms using attenuated total reflection Fourier transform infrared spectroscopy. , 1998, Biomaterials.