Yang Luo, Whiteside Samantha, Cadieux Peter A, Denstedt John D
Department of Surgery, Division of Urology, No.4 West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Urology of West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Asian J Urol. 2015 Oct;2(4):194-201. doi: 10.1016/j.ajur.2015.08.006. Epub 2015 Sep 21.
Ureteral stents are commonly used following urological procedures to maintain ureteral patency. However, alongside the benefits of the device, indwelling stents frequently cause significant patient discomfort (pain, urgency, frequency) and can become encrusted and infected. The importance of these sequelae is that they are not only bothersome to the patient but can lead to significant morbidity, urinary retention, ureteral damage, recurrent infections, pyelonephritis and sepsis. When these problems occur, stent removal or replacement alongside antibiotic, analgesic and/or other symptom-modifying therapies are essential to successfully treat the patient. In an attempt to prevent such morbidity, numerous approaches have been investigated over the past several decades to modify the stent itself, thereby affecting changes locally within the urinary tract without significant systemic therapy. These strategies include changes to device design, polymeric composition, drug-elution and surface coatings. Of these, drug-elution and surface coatings are the most studied and display the most promise for advancing ureteral stent use and efficacy. This article reviews these two strategies in detail to determine their clinical potential and guide future research in the area.
输尿管支架常用于泌尿外科手术后以维持输尿管通畅。然而，在该器械带来益处的同时，留置支架常常会给患者带来明显不适（疼痛、尿急、尿频），并且可能会形成结石并感染。这些后遗症的重要性在于，它们不仅会给患者带来困扰，还可能导致严重的发病情况，如尿潴留、输尿管损伤、反复感染、肾盂肾炎和败血症。当出现这些问题时，取出或更换支架并配合使用抗生素、镇痛药和/或其他缓解症状的疗法对于成功治疗患者至关重要。为了预防此类发病情况，在过去几十年里人们研究了多种方法来改进支架本身，从而在不进行重大全身治疗的情况下影响尿路局部的变化。这些策略包括改变器械设计、聚合物成分、药物洗脱和表面涂层。其中，药物洗脱和表面涂层的研究最多，并且在推进输尿管支架的应用和疗效方面最具前景。本文详细综述了这两种策略，以确定它们的临床潜力并指导该领域未来的研究。
