Journal List > Korean J Urol > v.47(8) > 1069968

Lim, Han, Gil, Shin, So, Kim, Yuk, Kim, Yoon, Sul, and Na: The Evaluation of a Dissolvable Ureteral Catheter in a Rabbit Model

Abstract

Purpose

Ureteral stents are commonly placed after routine ureteroscopic procedures to prevent acute obstruction. However, stents can cause significant symptoms and they can require a secondary procedure for removal; further, they may possibly be forgotten. In order to overcome these problems, a temporary ureteral drainage stent capable of dissolving spontaneously was developed to evaluate the tissue reaction and toxicity.

Materials and Methods

We developed a dissolvable ureteral catheter composed of polydioxanone (PDO). We evaluated the toxicity and tissue reaction by hematologic (CBC, aminotransferase/alanine transaminase (AST/ALT), blood urea nitrogen, creatinine (BUN, Cr), alkaline phosphatase) and histologic examination (ureter, kidney and liver tissue). Twelve rabbits were placed into groups of four rabbits each: the uninserted control group, group I that had a dissolvable ureteral catheter inserted with harvest at four weeks, group II that had a dissolvable ureteral catheter inserted with harvest at eight weeks, and group III that had a dissolvable ureteral catheter inserted with harvest at twelve weeks.

Results

On histologic examination, the ureter had a normal appearance of transitional cells and it contained the dissolvable ureteral catheter in the ureteral lumen without any inflammatory change. The ureteral surface cells appeared normal after contact with the dissolvable ureteral catheter during the 12 weeks. Liver and kidney tissue showed mild focal inflammatory change, but no definitive difference was noted between the control and groups I, II and III. On the hematologic examination, there was no significant change of the value of CBC, AST/ALT, BUN, Cr and alkaline phosphatase due to the inserted dissolvable ureteral catheter during the 12 weeks.

Conclusions

A dissolvable ureteral catheter appeared to have no toxic effect, as evidenced by histological and hematological examination. However, further study is warranted in order to overcome the catheter's limitations like for its flexibility.

Figures and Tables

Fig. 1
(A) Preparation of p-dioxanone monomer via dehydrogenation, (B) polymerization mechanisms of p-dioxanone to poly (p-dioxanone).
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Fig. 2
The shape of the dissolving ureteral catheters.
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Fig. 3
Fluid collection method.
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Fig. 4
Weight loss of the polydioxanone ureteral stent according to the immersion time.
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Fig. 5
The change of the polydioxanone ureteral catheter surface according to the immersion time. (A) 0 weeks, (B) 8 weeks, (C) 20 weeks, (D) 28 weeks.
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Fig. 6
The change of the polydioxanone ureteral catheter surface as viewed by scanning electron microscopy (SEM). (A) Control, (B) 2 week later, (C) 8 week later, (D) control (Lt) and 8 week later (Rt).
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Fig. 7
7. Histological examination of the ureteral cross section after 4 weeks of the indwelling dissolvable ureteral catheter. Normal appearance of the ureteral transitional cells. There are no visible inflammatory changes and the arrow indicates the dissolving ureteral catheter in the ureteral lumen (H&E stain, ×40). (A) Group I, (B) Group II, (C) Group III.
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Fig. 8
Histological examination of the ureteral cross section after 4 weeks of the indwelling ureteral catheter (A) and the indwelling dissolving ureteral catheter (B) (H-E stain, ×40).
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Table 1
Measurements of flow resistance
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Table 2
The results of hematologic examination and urine analysis
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AST: aspartate aminotransferase (IU/l), ALT: alanine aminotransferase (IU/l), ALP: alkaline phosphatase (IU/l), BUN: blood urea nitrogen (mg/dl), Cr: creatinine (mg/dl), RBC: red blood cell, WBC: white blood cell

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