23 research outputs found

    Investigating the flow dynamics in the obstructed and stented ureter by means of a biomimetic artificial model.

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    Double-J stenting is the most common clinical method employed to restore the upper urinary tract drainage, in the presence of a ureteric obstruction. After implant, stents provide an immediate pain relief by decreasing the pressure in the renal pelvis (P). However, their long-term usage can cause infections and encrustations, due to bacterial colonization and crystal deposition on the stent surface, respectively. The performance of double-J stents - and in general of all ureteric stents - is thought to depend significantly on urine flow field within the stented ureter. However very little fundamental research about the role played by fluid dynamic parameters on stent functionality has been conducted so far. These parameters are often difficult to assess in-vivo, requiring the implementation of laborious and expensive experimental protocols. The aim of the present work was therefore to develop an artificial model of the ureter (i.e. ureter model, UM) to mimic the fluid dynamic environment in a stented ureter. The UM was designed to reflect the geometry of pig ureters, and to investigate the values of fluid dynamic viscosity (?), volumetric flow rate (Q) and severity of ureteric obstruction (OB%) which may cause critical pressures in the renal pelvis. The distributed obstruction derived by the sole stent insertion was also quantified. In addition, flow visualisation experiments and computational simulations were performed in order to further characterise the flow field in the UM. Unique characteristics of the flow dynamics in the obstructed and stented ureter have been revealed with using the developed UM

    Investigating the flow dynamics in the obstructed and stented ureter by means of a biomimetic artificial model

    Get PDF
    Double-J stenting is the most common clinical method employed to restore the upper urinary tract drainage, in the presence of a ureteric obstruction. After implant, stents provide an immediate pain relief by decreasing the pressure in the renal pelvis (P). However, their long-term usage can cause infections and encrustations, due to bacterial colonization and crystal deposition on the stent surface, respectively. The performance of double-J stents - and in general of all ureteric stents - is thought to depend significantly on urine flow field within the stented ureter. However very little fundamental research about the role played by fluid dynamic parameters on stent functionality has been conducted so far. These parameters are often difficult to assess in-vivo, requiring the implementation of laborious and expensive experimental protocols. The aim of the present work was therefore to develop an artificial model of the ureter (i.e. ureter model, UM) to mimic the fluid dynamic environment in a stented ureter. The UM was designed to reflect the geometry of pig ureters, and to investigate the values of fluid dynamic viscosity (μ), volumetric flow rate (Q ) and severity of ureteric obstruction (OB%) which may cause critical pressures in the renal pelvis. The distributed obstruction derived by the sole stent insertion was also quantified. In addition, flow visualisation experiments and computational simulations were performed in order to further characterise the flow field in the UM. Unique characteristics of the flow dynamics in the obstructed and stented ureter have been revealed with using the developed UM

    Flow Dynamics in Stented Ureter

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    Urinary flow is governed by the principles of fluid mechanics. Urodynamic studies have revealed the fundamental kinematics and dynamics of urinary flow in various physiological and pathological conditions, which are cornerstones for future development of diagnostic knowledge and innovative devices. There are three primary approaches to study the fluid mechanical characteristics of urinary flow: reduced order, computational, and experimental methods. Reduced-order methods exploit the disparate length scales inherent in the system to reveal the key dominant physics. Computational models can simulate fully three-dimensional, time-dependent flows in physiologically-inspired anatomical domains. Finally, experimental models provide an excellent counterpart to reduced and computational models by providing physical tests under various physiological and pathological conditions. While the interdisciplinary approaches to date have provided a wealth of insight into the fluid mechanical properties of the stented ureter, the next challenge is to develop new theoretical, computational and experimental models to capture the complex interplay between the fluid dynamics in stented ureters and biofilm/encrustation growth. Such studies will (1) enable identification of clinically relevant scenarios to improve patients’ treatment, and (2) provide physical guidelines for next-generation stent design

    Fluid mechanical modeling of the upper urinary tract

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    The upper urinary tract (UUT) consists of kidneys and ureters, and is an integral part of the human urogenital system. Yet malfunctioning and complications of the UUT can happen at all stages of life, attributed to reasons such as congenital anomalies, urinary tract infections, urolithiasis and urothelial cancers, all of which require urological interventions and significantly compromise patients' quality of life. Therefore, many models have been developed to address the relevant scientific and clinical challenges of the UUT. Of all approaches, fluid mechanical modeling serves a pivotal role and various methods have been employed to develop physiologically meaningful models. In this article, we provide an overview on the historical evolution of fluid mechanical models of UUT that utilize theoretical, computational, and experimental approaches. Descriptions of the physiological functionality of each component are also given and the mechanical characterizations associated with the UUT are provided. As such, it is our aim to offer a brief summary of the current knowledge of the subject, and provide a comprehensive introduction for engineers, scientists, and clinicians who are interested in the field of fluid mechanical modeling of UUT

    Ureteric Perturbation and Obstruction

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    Nanoparticles: Potential for Use to Prevent Infections

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    One of the major issues related to medical devices and especially urinary stents are infections caused by different strains of bacteria and fungi, mainly in light of the recent rise in microbial resistance to existing antibiotics. Lately, it has been shown that nanomaterials could be superior alternatives to conventional antibiotics. Generally, nanoparticles are used for many applications in the biomedical field primarily due to the ability to adjust and control their physicochemical properties as well as their great reactivity due to the large surface-to-volume ratio. This has led to the formation of a new research field called nanomedicine which can be defined as the use of nanotechnology and nanomaterials in diagnostics, imaging, observing, prevention, control, and treatment of diseases. For example, coverings or coatings based on nanomaterials are now seen as a promising strategy for preventing or treating biofilms formation on healthcare kits, implants, and medical devices. Toxicity, inappropriate delivery, or degradation of conventionally used drugs for the treatment of infections may be avoided by using nanoparticles without or with encapsulated/immobilized active substances. Most of the materials which are used and examined for the preparation of the nanoparticles with encapsulated/immobilized active substances or smart reactive nanomaterials with antimicrobial effects are polymers, naturally derived antimicrobials, metal-based and non-metallic materials. This chapter provides an overview of the current state and future perspectives of the nanoparticle-based systems based on these materials for prevention, control, or elimination of biofilm-related infections on urinary stents. It also addresses manufacturing conditions indicating the huge potential for the improvement of existing and development of new promising stent solutions

    Urinary Stents

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    This open access book provides a concise overview of a range of aspects related to urinary stents. Sections within the work cover clinical and recent technological advancements in the field. Chapters feature detailed coverage of the different surgical, pharmacological and palliative treatments currently available. Insight is also given on current limitations of urinary stents and how these can be overcome by utilizing anti-biofilm coatings; new biomaterials, drug-eluting stents, and biodegradable stents. Therefore, enabling the reader to systematically gain a detailed understanding of the subject. Urinary Stents is a practical, multi-disciplinary focused resource on the complications and applications of ureteral, urethral and prostatic stents in day-to-day clinical practice. A vital read for all medical professionals and researchers who work in this area

    Urinary Stents

    Get PDF
    This open access book provides a concise overview of a range of aspects related to urinary stents. Sections within the work cover clinical and recent technological advancements in the field. Chapters feature detailed coverage of the different surgical, pharmacological and palliative treatments currently available. Insight is also given on current limitations of urinary stents and how these can be overcome by utilizing anti-biofilm coatings; new biomaterials, drug-eluting stents, and biodegradable stents. Therefore, enabling the reader to systematically gain a detailed understanding of the subject. Urinary Stents is a practical, multi-disciplinary focused resource on the complications and applications of ureteral, urethral and prostatic stents in day-to-day clinical practice. A vital read for all medical professionals and researchers who work in this area

    Progenitor cells in auricular cartilage demonstrate promising cartilage regenerative potential in 3D hydrogel culture

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    The reconstruction of auricular deformities is a very challenging surgical procedure that could benefit from a tissue engineering approach. Nevertheless, a major obstacle is presented by the acquisition of sufficient amounts of autologous cells to create a cartilage construct the size of the human ear. Extensively expanded chondrocytes are unable to retain their phenotype, while bone marrow-derived mesenchymal stromal cells (MSC) show endochondral terminal differentiation by formation of a calcified matrix. The identification of tissue-specific progenitor cells in auricular cartilage, which can be expanded to high numbers without loss of cartilage phenotype, has great prospects for cartilage regeneration of larger constructs. This study investigates the largely unexplored potential of auricular progenitor cells for cartilage tissue engineering in 3D hydrogels
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