A novel ureteric stent coating reduces encrustation and improves tolerability in a randomised trial

OBJECTIVES: To evaluate the effect of a novel sulfonic acid-coated ureteric stent on encrustation and quality of life in patients with urolithiasis. PATIENTS AND METHODS: A prospective, randomised, controlled trial was conducted between April 2022 and March 2025 at two urological centres in Germany. In all, 100 patients requiring ureteric stenting due to urolithiasis were randomised into intervention and control groups. All patients received identical stents (6 F/28 cm); the stent in the intervention group incorporated a novel covalent coating. Stents were removed after 30 days during secondary stone treatment, followed by the encrustation weight assessment. Symptoms associated with the ureteric stent and quality of life were evaluated using the Ureteric Stent Symptom Questionnaire 7 days after stent placement and 7 days after stent removal. RESULTS: The final analysis included 95 patients assessed for the primary endpoint. Coated stents showed a 49.7% reduction in mean encrustation weight (mean difference 22.8 mg, 95% confidence interval [CI] 2.4-43.2; P = 0.006). The increase in lower urinary tract symptoms was 53.8% less in the coated-stent group (Δ3.6 [95% CI 1.3-6] vs Δ7.8 [95% CI 2.8-12.8]; P = 0.002). Light physical activities improved by 33.9% (mean difference 0.76, 95% CI 0.08-1.44; P = 0.046), and the need for antimicrobial therapy was significantly lower for coated stents (7.1% vs 31.8%, P = 0.02; odds ratio 6.1, 95% CI 1.11-33.1). Additionally, patients in the coated-stent group reported significantly less fatigue and exhaustion symptoms (mean difference 0.67, 95% CI 0.02-1.32; P = 0.03). CONCLUSION: The novel sulfonic acid coating demonstrated significant benefits over standard ureteric stents by reducing encrustation and improving quality of life.