Resist encrustation

Encountering an encrusted ureteral stent can be all too common when managing numerous urological conditions. Stent encrustation is a serious complication,¹ and it presents a significant clinical challenge.² Polymer stents are the industry standard but quickly become encrusted with stone material and must be exchanged every 3–4 months.³ Cook Medical’s Resonance® Metallic Ureteral Stent, with its patented coil design and 12-month indwell time,⁴ gives physicians an option to counter encrustation.

For many physicians, encrustation is high on their list of challenges because it can result in significant morbidities such as stone formation, reoccurring obstruction, and urinary tract infection (UTI).⁵ Finding a solution isn’t always easy. Research has found “a variety of factors contribute to the rate at which this process [encrustation] occurs,” including urine composition, the material a stent is made from, and how long the stent remains indwelling.⁶ For patients who have had stones before and for those who need to be stented for longer periods of time, the risk of encrustation increases.⁶

A physician can take certain steps—like choosing a stent that resists encrustation—to help lower a patient’s risk.

“One advantage of [the Resonance] stent over traditional polymer-based stents is resistance to encrustation with stone material, which allows longer dwell times and less frequent exchange procedures.”⁷

The Resonance stent is used for temporary stenting of the ureter in adult patients with extrinsic ureteral obstruction. The stent is specifically designed to mitigate many of the problems encountered with traditional polymer stents and other forms of treatment. The optimised compressive and radial strength of the Resonance stent, and its resistance to encrustation,⁸ allow the stent to remain indwelling for up to 12 months. This long indwelling time reduces the need for frequent stent changes and may thereby decrease the risk of infection.

When it comes to a prolonged indwell time, decreasing the risk of infection and resisting encrustation can only occur if everyone involved understands how a stent should be managed. Patient education is imperative and physicians should ensure their patients “understand the importance of proper follow-up and timely stent removal.”² The physician must clearly state the temporary nature of a stent, the risks of long indwelling times, and the need for follow-up appointments in order to help to avoid complications.⁶

Learn more about the Resonance stent or request information here.

1. Bultitude MF, Tiptaft RC, Glass JM, et al. Management of encrusted ureteral stents impacted in upper tract. Urology. 2003;62(4):622-626.
2. Talwar R, Benson M, Fam M, et al. The open approach to severe stent encrustation: a consecutive case series. Urology. 2017;99:e1-e3.
3. Venkatesan N, Shroff S, Jayachandran K, et al. Polymers as ureteral stents. J Endourol. 2010;24(2):191–198.
4. Wah TM, Irving HC, Cartledge J. Initial experience with the Resonance metallic stent for antegrade ureteric stenting. Cardiovasc Intervent Radiol. 2007;30(4):705-710.
5. Dakkak Y, Janane A, Ould-Ismail T, et al. Management of encrusted ureteral stents. African J Urol. 2012;18(3):131-134.
6. Vanderbrink BA, Rastinehad AR, Ost MC, et al. Encrusted urinary stents: evaluation and endourologic management. J Endourol. 2008;22(5):905-912.
7. Rao MV, Polcari AJ, Turk TM. Updates on the use of ureteral stents: focus on the Resonance stent. Med Devices (Auckl). 2011;4:11-15.
8. López-Huertas HL, Polcari AJ, Acosta-Miranda A, et al. Metallic ureteral stents: a cost-effective method of managing benign upper tract obstruction. J Endourol. 2010;24(3):483-485.