RECONSTRUCTIVE UROLOGY

Urinary tract biomaterials
Beiko DT, Knudsen BE, Watterson JD, Cadieux PA, Reid G, Denstedt JD
Department of Urology, Queen’s University, Kingston, University of Western Ontario, London, Ontario, Canada
J Urol. 2004; 171: 2438-2444

• Purpose: As a result of endourological advances, biomaterials have become increasingly used within the urinary tract. This review article provides an update on the current status of urinary tract biomaterials, discussing issues of biocompatibility, biomaterials available for use, clinical applications and biomaterial related complications. Perspectives on future materials for use in the urinary tract are also provided.
• Materials and Methods: We performed a comprehensive search of the peer reviewed literature on all aspects of biomaterials in the urinary tract using PubMed and MEDLINE. All pertinent articles were reviewed in detail.
• Results: Any potential biomaterial must undergo rigorous physical and biocompatibility testing prior to its commercialization and use in humans. There are currently many different bulk materials and coatings available for the manufacturing of biomaterials, although the ideal material has yet to be discovered. For use in the urinary tract, biomaterials may be formed into devices, including ureteral and urethral stents, urethral catheters and percutaneous nephrostomy tubes. Despite significant advances in basic science research involving biocompatibility issues and biofilm formation, infection and encrustation remain associated with the use of biomaterials in the urinary tract and, therefore, limit their long-term indwelling time.
• Conclusions: Prosthetic devices formed from biomaterials will continue to be an essential tool in the practicing urologist’s armamentarium. Ongoing research is essential to optimize biocompatibility and decrease biomaterial related complications such as infection and encrustation within the urinary tract. Future advances include biodegradables, novel coatings and tissue engineering.
  
  
• Editorial Comment
  This is a nice overview of the increasing number of biomaterials which can be used for and around the urinary tract. However, ongoing research is an absolute must because biocompatibility, interactions with body tissues and subsequent scaring are far from ideal with the current materials.

Dr. Arnulf Stenzl
Professor and Chairman of Urology
Eberhard-Karls-University Tuebingen
Tuebingen, Germany