A Novel Smart Tailorable Degradable Ureteral Stent with Dynamically Reconfigurable Hydrogel Network for Urologic Surgery.

Abstract

Every year, millions of ureteroscopy patients must return for a second procedure to remove the ureteral stent, doubling both costs and infection risk. Biodegradable stents offer a promising solution by eliminating this second procedure, but achieving an optimal balance between robust mechanical performance, precise degradation kinetics, and excellent biocompatibility remains a major challenge. A novel tailorable biodegradable hydrogel ureteral stent (GAS) designed from Gelatin Methacryloyl (GelMA) and Alginate Methacryloyl (AlgMA), utilizing double network crosslinking and Hofmeister stretching treatment for programmed degradation. This design not only significantly enhances the stent's mechanical performance but also proposes a dynamic hydrogen bonds reconfiguration and crosslinking density tailorable degradation strategy to optimize degradation kinetics. By adjusting dynamic hydrogen bonds and optimizing GelMA concentration, GAS achieves adjustable degradation times ranging from 2 to 4 weeks. Furthermore, in animal models, not only can the degradation time be controlled within a range of 2-4 weeks, but the stents also exhibit lower signs of inflammation or fibrosis compared to clinically commonly used stents. In essence, GAS represents a simple yet powerful strategy for customizing the degradation kinetics of biomedical implants, and this stent is poised to significantly improve postoperative care and outcomes for ureteroscopy patients.