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Potential strategies to prevent encrustations on urinary stents and catheters -thinking outside the box A European Network of Multidisciplinary Research to Improve Urinary Stents (ENIUS) Initiative *
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Edité par CCSD ; Expert Reviews -
International audience. Background: Urinary stents have been around for the last 4 decades, urinary catheters even longer. Although a lot of effort has gone into improving these devices in terms of materials, coatings and designs, they still suffer from inherent problems such as infections, encrustation, blockage, migration and patient discomfort. Research efforts have shifted onto the molecular and cellular levels, taking into consideration many aspects of the microenvironment (the physio-chemical composition of urine). The European Network of Multidisciplinary Researchto Improve Urinary Stents (ENIUS) brought together European translational scientists for knowledge exchange and brainstorming towards improving urinary implants and reduce their morbidity.Methods & materials:The authors on this paper formed a working group within the ENIUS network tasked with assessing future research lines for the improvement of urinary implants. The topic was researched according to PRISMA. Then relevant sub-topics were addressed with a separate PRISMA search. As this was done for each individual chapter, an overall collection of search terms and PRISMA diagrams seems not practical in the framework of this paper.Results: Sub-topics deemed relevant for urology and promising in their approach were antibody, enzyme, biomimetic, and bioactive nano-coatings, coating with antisense molecules, and coating with autologous engineered tissue. Further physico chemical approaches such as pH-change sensors, biodegradable metals, use of bactericidal bacteriophages and non-pathogenic competitive uropathogens, and the use of enhanced ureteric peristalsis, electrical charges and ultrasound to prevent stent encrustations.Conclusions: All research lines addressed in this paper seem to date viable and promising. Some of them have been around for decades but have yet to proceed to clinical application (i.e. tissue engineering). Others are very recent and, at least in urology, still only conceptual (i.e. antisense molecules). Perhaps the most important learning point resulting from this pan- European multidisciplinary effort is that collaboration between all stakeholders is not only fruitful but truly essential.
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