Abstract

Encrustations of ureteral stents are one of the biggest problems with urological implants. Crystalline biofilms can occur alone or in combination with bacterial biofilms. To identify which surface parameters provide guidance for the development of novel stent materials, we used an in vitro encrustation system. Synthetic urine with increasing pH to simulate an infection situation was pumped over the polymer samples with adjusted flow rates at 37 °C to mimic the native body urine flow. Chemical surface features (contact angle, surface charge), as well as encrustations were characterized. The encrustations on the materials were analyzed quantitatively (dry mass) and qualitatively using scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDX), and Fourier transform infrared spectroscopy (FTIR). The aim of this comparative study was to identify crucial surface parameters that might predict the quantity and type of mineral deposits in vitro and provide guidance for the development and screening of new polymer-based biomaterials for ureteral stent design. For the first time, we could identify that, within the range of our polymers, those materials with a slight hydrophilicity and a strong negative zeta potential (around −60 mV) were most favorable for use as ureteral stent materials, as the deposition of crystalline biofilms was minimized.

Highlights

  • IntroductionDespite the risks associated with the use of stents, urinary stents are one of the most frequently used human implants

  • Ureteral stents are used for temporary, as well as long-term stenting of the ureter

  • The pH is elevated, and this alters the solubility of magnesium and calcium salts, leading to more magnesium phosphate encrustations [9]

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Summary

Introduction

Despite the risks associated with the use of stents, urinary stents are one of the most frequently used human implants. Complications of stents, like biofilm formation or encrustation, promote urinary tract infections and cause disorders in wound healing [1]. Stent-associated urinary tract infections are among the most common (25% to 40%) nosocomial infections [2,3]. Additional dangers are the frequently occurring encrustations of the stents that are triggered by the precipitation of salt crystals [4]. The development of urinary stones in patients has multiple causes, whereby genetic, dietary, climatic, and socioeconomic factors play a role [5]. In the absence of an infection, the gender-spanning dominant urinary stone type is calcium-containing stones [6], mainly calcium oxalate monohydrate

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