Surface modification of ureteral stents: development history, classification, function, and future developments

ABSTRACT

Introduction

Ureteral stents are commonly used in urology but are frequently associated with hematuria, abdominal discomfort, urinary tract infection, stent displacement, and stent encrustation. Surface modification of ureteral stents is beneficial to solve the problem, and these can be divided into coated stents and drug-eluting stents according to the modification method. Coated stents can be divided into hydrophilic coatings, antibacterial coatings, and anti-encrustation coatings. Drug-eluting stents can be divided into antimicrobial drug-eluting, antispasmodic analgesic drug-eluting, anti-ureteral stricture drug-eluting, and anti-tumor drug-eluting. Surface modification of ureteral stents can not only reduce complications related to ureteral stents but also strengthen the treatment of certain urologic diseases, which has a high clinical application value.

Areas covered

This review focuses on highlighting and summarizing the latest research progress about surface modification of ureteral stents, ureteral stent development history, classification, functions, and future development prospects.

Expert Opinion

The purpose of this article is to discuss surface modification of ureteral stents to reduce stent-related complications and potential research directions for the treatment of urinary tract tumors are also briefly discussed, to help guide further innovation in ureteral stent coatings, which contribute to the future progress of ureteral stents surface modification.

KEYWORDS:

• Ureteral stent
• urinary tract diseases
• complications
• functionalized coating
• development prospects

Article highlights

• The incidence of urinary tract diseases has been increasing, and ureteral stents are widely used in the surgical treatment of various diseases of the urinary system, such as urinary calculi, hydronephrosis, and obstruction at the ureteropelvic junction.

• Ureteral stents implantation easily leads to infection, encrustation, hematuria, and other complications. Surface modification of ureteral stents can effectively reduce complications, reduce patients’ pain and medical costs.

• Surface modification of ureteral stents is generally divided into two categories: stent coating and drug-eluting. Stent coating includes hydrophilic coating, antimicrobial coating, and anti-encrustation coating, whereas drug eluting stent includes antimicrobial drug-eluting stents， antispasmodic analgesic drug-eluting stents，anti-ureteral stricture drug-eluting stents, and anti-tumor drug-eluting stents.

• In addition, drug-eluting stents can deliver drugs directly to the ureter and renal pelvis, which could be used for the treatment of ureteral stricture and early urinary tumors in the future.

• At present, there are many basic studies on coated stents, but most of them cannot be clinically applied. Uncertain efficacy and safety of coated stents and the lack of standardized production standards are the main difficulties in this transformation.

Declaration of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewers disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Author contributions

KX and ZH were in charge of designing the article; KX, XS and XA are in charge of writing, and BH, YC, and KZ are in charge of searching and sorting out the literature.

Additional information

Funding

This study was supported by the National Natural Science Foundation of China (82070724), the Natural Science Foundation of Anhui Province (1908085MH246)