Adverse Effects of Ureteral Stent and Development of the Antireflux Ureteral Stent

Jung Woo Lee; Chang-Ju Park; Sangdo Jeong; Jong-Hyun Lee; Hong Sang Moon

doi:10.7599/hmr.2013.33.3.178

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Lee, Park, Jeong, Lee, and Moon: Adverse Effects of Ureteral Stent and Development of the Antireflux Ureteral Stent

Review Article

Hanyang Medical Reviews 2013; 33(3): 178-184.

Published online: 21 August 2013

DOI: https://doi.org/10.7599/hmr.2013.33.3.178

Adverse Effects of Ureteral Stent and Development of the Antireflux Ureteral Stent

Jung Woo Lee¹, Chang-Ju Park², Sangdo Jeong², Jong-Hyun Lee², Hong Sang Moon¹

¹Department of Urology, Hanyang University College of Medicine, Guri, Korea.

²Department of Medical System Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju, Korea.

Correspondence to: Hong sang Moon. Department of Urology, Hanyang University Guri Hospital, 153 Gyeongchun-ro, Guri 471-701, Korea. Tel: +82-31-560-2374, Fax: +82-31-560-2370, moonuro@hanyang.ac.kr

Received 24 May 2013 Revised 22 July 2013 Accepted 28 July 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The double J ureteral stent (D-J stent) represents the ureteral catheter widely used nowadays. The main purpose of the D-J stent is to resolve ureteral obstruction caused by intraureteral or extra-ureteral etiologies. Indications of D-J stents have been extended and it has become one of the most important surgical instruments that protect the kidney and ureter. The ideal D-J stent should be easy to insert and remove and should not cause any adverse effects in vivo. In addition, it has to function well. However, there has been no immaculate D-J stent because our body conceives the ureteral stent as a foreign object and numerous developments are being made in order to overcome it. Vesicoureteral reflux, one of the adverse effects of the D-J stent, is the most troublesome adverse effect because it may scar the renal parenchyma, leading to permanent deterioration of renal function. This review is to discuss adverse effects of ureteral stents and to present the novel antireflux D-J stent that may reduce vesicoureteral reflux.

Keywords: Ureter, Stents, Prosthesis Design, Postoperative Complications, Vesico-Ureteral Reflux

Figures and Tables

Fig. 1

Normal position and shape of D-J ureteral catheter in the right ureter.

Fig. 2

Biomaterials of ureteral stents. (A) Polyurethane, (B) Metal.

Fig. 3

Malposition of D-J ureteral catheter in the left ureter. (A) The proximal tip of D-J ureteral catheter looks like "fish reeling" which means the typical shape of malposition. (B) The proximal tip of D-J ureteral catheter is in the upper ureter lumen.

Fig. 4

Migration of distal tip of the D-J ureteral catheter to the bladder neck.

Fig. 5

Schematic design of antireflux valve with 4 flaps: (A) P₁<P₂ (Open), (B) P₁>P₂ (Close). ^*P (Pressure).

Fig. 6

Photo images of the antireflux stent. (A) Antireflux valve, (B) D-J stent bonded with an antireflux valve, (C) D-J stent connected to guide wire.

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