Korean J Urol.  2006 Aug;47(8):895-902. 10.4111/kju.2006.47.8.895.

The Evaluation of a Dissolvable Ureteral Catheter in a Rabbit Model

• Lim JS
• Han DS
• Gil G
• Shin JH
• So SM
• Kim YW
• Yuk SM
• Kim HS
• Yoon YR
• Sul CK
• Na YG

• KMID: 2294121
• DOI: http://doi.org/10.4111/kju.2006.47.8.895

Abstract

PROPOSE: 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.

Keyword

Ureteral catheterization

MeSH Terms

Alkaline Phosphatase
Blood Urea Nitrogen
Creatinine
Drainage
Kidney
Liver
Pliability
Polydioxanone
Rabbits
Stents
Ureter*
Urinary Catheterization
Urinary Catheters*
Alkaline Phosphatase
Creatinine
Polydioxanone

Figure

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  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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