Functional Properties of Polyurethane Ureteral Stents with PLGA and Papaverine Hydrochloride Coating

Magdalena Antonowicz,Janusz Kasperczyk,Bożena Gzik-Zroska,Kamil Joszko,Karla Čech Barabaszová,Zbigniew Paszenda,Joanna Jaworska,Katarzyna Jelonek,Damian S Nakonieczny,Paweł M Nuckowski,Piotr Bryniarski,Janusz Szewczenko

doi:10.3390/ijms22147705

Abstract

Despite the obvious benefits of using ureteral stents to drain the ureters, there is also a risk of complications from 80–90%. The presence of a foreign body in the human body causes disturbances in its proper functioning. It can lead to biofilm formation on the stent surface, which may favor the development of urinary tract infections or the formation of encrustation, as well as stent fragmentation, complicating its subsequent removal. In this work, the effect of the polymeric coating containing the active substance-papaverine hydrochloride on the functional properties of ureteral stents significant for clinical practice were assessed. Methods: The most commonly clinically used polyurethane ureteral Double-J stent was selected for the study. Using the dip-coating method, the surface of the stent was coated with a poly(D,L-lactide-glycolide) (PLGA) coating containing the papaverine hydrochloride (PAP). In particular, strength properties, retention strength of the stent ends, dynamic frictional force, and the fluoroscopic visibility of the stent during X-ray imaging were determined. Results: The analysis of the test results indicates the usefulness of a biodegradable polymer coating containing the active substance for the modification of the surface of polyurethane ureteral stents. The stents coated with PLGA+PAP coating compared to polyurethane stents are characterized by more favorable strength properties, the smaller value of the dynamic frictional force, without reducing the fluoroscopic visibility.

Highlights

Ureteral stents used for treatment of the upper urinary tract are implantable devices that support the flow of the urine from the kidneys to the bladder
The copolymers were synthesized in bulk by the ring opening polymerization (ROP) of glycolide (Purac) and D,L lactide (Purac) at 130 ◦C for 24 h, at 120 ◦C for 48 h under argon using the initiator: zirconium acetylacetonate (Zr(acac)4)
The active substance was added to the resulting solution the diastolic drug papaverine hydrochloride (C20H21NO4·HCl) (Sigma-Aldrich, Darmstadt, Germany) (20% of the drug by weight of the polymer) (PLGA+PAP)

Summary

Introduction

Ureteral stents used for treatment of the upper urinary tract are implantable devices that support the flow of the urine from the kidneys to the bladder. The most commonly used stent construction today is “Double-J” DJ. It was first introduced by Finney in 1978. The DJ stent is placed in the ureter, which functions as a low pressure, stretchy tube with its own peristalsis. Due to contractions of the muscle membrane, peristaltic movements of the ureter take place, which transport urine from the renal pelvis to the bladder. Systolic waves disappear when the bladder is too full, but intensify when the lumen of the ureter is closed, e.g., by a stone. This type of contraction is very painful and is known as renal colic. The authors [12] concluded that the ureteral tissue is stiffer in the longitudinal direction than in the circumferential direction and that perhaps the collagen fibers are along the axial axes

Methods

Results

Conclusion