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Handbook of Urinary Stents: Basic Science and Clinical Applications
Noor Buchholz, Oliver Hakenberg, Junaid Masood, Christian Bach
SECTION 1: URETER STENTS
1:
History of ureteric stents
Coiled ureteral double-J stents
Expandable metal and covered metal ureteric stents
2:
Physiology of stent flow
Mechanisms of flow through conventional JJ stents
Obstructed stents
Other types of ureteral stent
Reflux
Conclusion
3:
Stent materials and designs
Materials
Stent length
Novel designs
Stent complications: biofilms
Stent encrustation
Conclusion
4:
Urinary stent coatings
Anti-inflammatory coatings and elutions
Hydrophilic coatings
Biofilm suppression
Anticonditioning and antiadherence coatings
Antibacterial coatings and elutions
Novel antiquorum and cationic proteins
Biomimetic, biostable, and other bioactive coatings
Biomimetic coatings
Glycosaminoglycan coatings
Biostable coatings
Abacterial mineral encrustation
Tissue engineering and the future
SECTION 2: POLYMER STENTS
5:
Ureter stents: indications
Indications for stent placement
Blocked ureters
Post ureteroscopy and other endourological interventions
Ureteral anastomosis
Prophylactic stent use
Conclusion
6:
Polymer stents: insertion tips and tricks
Difficulties arising during a retrograde ureteric stent insertion
Failure to advance the guide wire through the ureter
Placing the ureteric stent
Antegrade ureteric stent placement
Exchanging ureteric stents
Stenting the anomalous urinary tract
Insertion of a ureteric stent during open or laparoscopic surgery
7:
Complications of ureteric stents and how to deal with them
Stent-related symptoms
Urinary tract infection and urosepsis
Misplacement and migration
Encrustation, obstruction and fragmentation
Perforation and injury of extra-ureteral structures
8:
How to deal with heavily encrusted stents
Stent encrustation
Symptoms
Diagnosis
Management
Prevention
Conclusion
9:
Medical management of ureteral stent-related symptoms
Medical therapy
Alpha-antagonists
Anticholinergics
Intravesical therapies
Current clinical practice
Conclusion
10:
Stents in children
Indications for stent placement
Ureteral obstruction
Ureteral anastomosis
Prophylactic use of stents
Stenting in children undergoing stone removal procedures
Stenting in pyeloplasty
Complications of stenting
11:
How not to forget the stent
Patient factors
Physician factors
The future
12:
Indwelling ureteric stents: the patient's stent experience and health- related quality of life
Ureteric stents: evaluation of symptoms and HRQoL
Development of a validated intervention (stent) specific patient-reported outcome measure (USSQ)
Ureteric stents: experience from different countries
Working toward solutions to improve the ‘stent experience’ and patients’ HRQoL
Physical properties and engineering solutions
Pharmacological solutions
Local applications
Systemic drug treatment
Patient counseling
Conclusion
SECTION 3: METAL STENTS
13:
The role of metal in stents
Metal stent development
Metal used for stents
Stent structure
Stent mechanics
Metal stents: pros and cons
Conclusion
14:
The Memokath stent
Ureteric Memokath stent 051
The Memokath stent principle
Indications
Absolute contraindications
Relative contraindications
Technical information
Insertion technique
Removal technique
Results and complications
Conclusion
Prostatic Memokath stent 028
Technical details
Indications
Contraindications
Insertion technique
Removal technique
Hospital stay
Results and complications
Conclusion
Urethral Memokath stent 044/045
Technical details
Indications
Contraindications
Relative contraindications
Insertion technique
Removal technique
Hospital stay
Results and complications
Conclusion
15:
The Resonance stent
Resonance stent insertion and exchange technique
Clinical experience
Cost-effectiveness of the Resonance stent
Conclusion
16:
The ureteral metal mesh stent
Types of MSs
Insertion technique
Clinical experience with ureteral metal mesh stents
Self-expandable MSs
Balloon expandable MSs
Thermo-expandable shape memory stents
Covered MSs
The future
Conclusion
17:
The Allium stent
Characteristics of the Allium ureteral stent (URS)
Clinical experience
Conclusion
18:
The Uventa stent
Stent design
Indications
Procedures
Clinical data: efficacy and safety
Tips and tricks
19:
Complications of metal stents in the ureter
Complications related to insertion and removal of stents
Insertion
Removal
Complications in the stented period
Immediate postoperative complications
Late complications related to patency
Migration
Malfunction
Encrustation
Tissue ingrowth
Progression of the stenosis
Stent-related symptoms
Conclusion
20:
Pathophysiology of encrustation in metal stents
Clinical presentation and complications of stent encrustation
The theory of encrustation on biomaterials exposed to urine
The formation of a biofilm
The role of urease in encrustation
Principles governing encrustation on metallic stents
Comparing encrustation in metallic versus conventional JJ polymer stents
Regulators of encrustation
Conclusion
21:
Prophylactic shock wave lithotripsy for metal stents
The concept of prophylactic SWL on metal stents
First in vitro studies
Conclusion and outlook for the future
22:
Quality of life with metal stents
Metallic stent complications
Self-expandable ureteral metal stents
Balloon expandable ureteral metal stents
Covered ureteral metal stents
All-metal double pigtail (Resonance) stent
Thermo-expandable shape memory stents (Memokath)
Conclusion
23:
Use of metal stents in transplant ureteral stricture
Minimally invasive alternative treatment options
Recent studies using the Memokath 051 in transplant ureteric strictures
Technique of insertion
Technique of removal
Technical information
Conclusion
24:
Using the Wallstent in the management of benign ureteroenteric anastomotic strictures in Bricker deviation
The Wallstent
Procedure
Follow-up
Definitions
Treatment results
Late onset
Other techniques
A second intervention
Conclusion
25:
Biodegradable materials in ureter stents
Biodegradable materials and additives in function modulation
Biodegradable ureteral stents: associated studies
Implantable stents
Non-implantable stents
Conclusion
26:
Drug-eluting ureter stents
Indications for temporary and permanent stents and indwelling catheters
Wound healing and its problems in ureteral anastomosis
Drug-eluting stents – antibiotics
Drug-eluting stents – antiproliferative drugs
Drug-eluting stents – drug reservoir/coupling
Drug-eluting stents – applications in urology
The future of drug-eluting stents
Polymer development
Non-resorbable metal stents
Complex biomaterials
New drugs and drug combinations
Biodegradable stents
Surface modifications
Summary and future developments
SECTION 4: LOWER URINARY TRACT STENTS
27:
History of lower urinary tract stenting
Stents for prostatic obstructions
Stents for urethral strictures
28:
Lower urinary tract stents: the ideal stent
Stent type
Temporary stents
Permanent stents
Conclusion
29:
Physiology of urethral flow
The micturition reflex
Urine storage and emptying
Mechanics of urine storage and flow
Hydrodynamics of male urethral flow
Practical implications
Conclusion
SECTION 5: PROSTATE STENTS
30:
Prostate stents: indications
Benign prostatic obstruction
Conclusion
31:
Temporary intraprostatic stents
First generation spiral stents
Second generation spiral stents
Polyurethane stents
Biodegradable stents
Conclusion
32:
The Memokath prostate stent
The principle of the Memokath stent
The Memokath prostate stent
Insertion and removal of the Memokath prostate stent
Limitations
Clinical studies
Future perspectives
Conclusion
33:
The UroLume prostate stent
Design
Clinical studies: outcomes and complications
Technique of insertion and removal
Conclusion
34:
The Allium prostate stent
The Allium stent
A study using the Allium stent in 14 patients
Inclusion criteria and contraindications
Surgical procedure and follow up
Results
Conclusion
35:
The Spanner prostatic stent
Sizing of the Spanner
Insertion
Removal
Advantages associated with the use of the Spanner
Side effects and complications
Contraindications
Clinical uses
Following transurethral microwave thermotherapy (TUMT)
Following brachytherapy
For symptomatic benign prostatic obstruction
For symptomatic benign and malignant prostatic obstruction in patients unfit for surgery
Conclusion
36:
Complications of prostate stents
Immediate complications
Early complications following implantation
Permanent stents
Temporary stents
Long-term complications
Conclusion
37:
The future role of prostatic stents
Benign outlet obstruction
Metal stents – permanent
Metal stents – temporary
Plastic stents
Combination of metal and plastic polymer stents
Biodegradable stents
Management of LUTS due to prostatic carcinoma and its treatment
Fiducials for radiotherapy of prostate cancer
Before and after BPH surgery and in lower urinary tract dysfunction
Practical considerations
SECTION 6: URETHRAL STENTS
38:
Urethral stents: indications
Urethral strictures – bladder neck contracture
Detrusor sphincter dyssynergia
39:
The Allium urethral stent
The Allium bulbo-urethral stent
Description
Advantages
The healing mould
Biostability to avoid local adverse reaction
Adapted radial force
Easy insertion and removal
Disadvantages
Results
Perioperative management
Conclusion
40:
The urethral stent and detrusor–sphincter dyssynergia
Indications for urethral stenting in DSD
Types of stents available for DSD management
Consenting the patient before urethral stenting for DSD
The stenting procedure
Expected outcomes
Conclusion
41:
The urethral stent and radiotherapy
Background
Prostate stent as fiducial marker
High geometric precision in radiotherapy using fiducial markers
Acute toxicity using fiducial markers
Clinical stent procedures
Insertion
Imaging and planning of radiotherapy treatment
Treatment
Removal
Result from radiotherapy with stent
Treatment efficacy
Late toxicity
Genitourinary toxicity
Gastrointestinal toxicity
Future application of stent fiducials
Conclusion
42:
Brachytherapy and the urethral stent
Evolution of brachytherapy
Brachytherapy and lower urinary tract morbidity
Bladder outflow obstruction following brachytherapy
Urethral stents
Conclusion
43:
The future role of urethral stents
Future role of urethral stents
Stricture disease
Benign prostatic hyperplasia
New therapies for treatment of prostate cancer
Neuropathic bladder dysfunction
Diseases where frequent cystoscopy is warranted
Conclusion
44:
Biodegradable stents of the lower urinary tract
Biodegradable urethral stents with spiral configuration
Biodegradable anterior urethral stents
Biodegradable prostatic stents
Stents in combination with thermal treatment of the prostate
Stents in combination with medical treatment of prostatic enlargement
Biodegradable spiral stents in other treatment indications
Biodegradable urethral stents with braided configuration
Biodegradable urethral stents with drug-eluting properties
Biodegradable stents as scaffolds for organic cells
Conclusion
45:
The future of ureteral stents
Stent design
Stent material
Stent coating
Conclusion
INDEX
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