Zheng Shaokai, Amado Pedro, Obrist Dominik, Burkhard Fiona, Clavica Francesco
ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Front Bioeng Biotechnol. 2022 Oct 11;10:1028325. doi: 10.3389/fbioe.2022.1028325. eCollection 2022.
models are indispensable to study the physio-mechanical characteristics of the urinary tract and to evaluate ureteral stent performances. Yet previous models mimicking the urinary bladder have been limited to static or complicated systems. In this study, we designed a simple bladder model to simulate the dynamics of filling and voiding. The physio-mechanical condition of the model was verified using a pressure-flow test with different bladder outlet obstruction levels, and a reflux test was performed to qualitatively demonstrate the stent associated vesicoureteral reflux (VUR). Finally, the setup was applied with and without the bladder model to perform encrustation tests with artificial urine on commercially available double-J stents, and the volumes of luminal encrustations were quantified using micro-Computed Tomography and image segmentation. Our results suggest that, VUR is an important factor contributing to the dynamics in the upper urinary tract with indwelling stents, especially in patients with higher bladder outlet obstruction levels. The influence of VUR should be properly addressed in future studies and clinical analyses.
模型对于研究尿路的生理力学特性以及评估输尿管支架性能而言不可或缺。然而,先前模拟膀胱的模型仅限于静态或复杂系统。在本研究中,我们设计了一个简单的膀胱模型来模拟充盈和排尿的动态过程。使用不同膀胱出口梗阻水平的压力-流量测试对模型的生理力学状况进行了验证,并进行了反流测试以定性地证明与支架相关的膀胱输尿管反流(VUR)。最后,在有和没有膀胱模型的情况下应用该装置,对市售双J支架进行人工尿液结垢测试,并使用微型计算机断层扫描和图像分割对管腔内结垢的体积进行量化。我们的结果表明,VUR是导致留置支架时上尿路动力学变化的一个重要因素,尤其是在膀胱出口梗阻水平较高的患者中。在未来的研究和临床分析中应适当考虑VUR的影响。